IMPORTANT NOTICE: Many stories
relating to Medicare appear in our section on
Senior Politics. News on the Medicare drug program is in its own
section - Click
Medicare News
Medicare Advocacy Groups Join to Blast CMS for
Promoting Private Advantage Plans
Organizations says it is “last-ditch effort” to
privatize Medicare by Bush administration
Jan. 12, 2009 – Some of the leading advocates for
Medicare beneficiaries have joined together to condemn actions by the
Centers for Medicare & Medicaid Services, which they think are designed
to “assure continued leniency in the oversight of private plans for at
least another year and as a last-ditch effort to promote private
Medicare Advantage plans.”
Read more...
CMS Declares Success in Hospital Program to Report
on Quality Measures
Seven elements measured were aimed at heart attack
and surgical care
Jan. 8, 2009 – More than 3,000 U.S. hospitals will
receive the full payment update for 2009 as part of the new Hospital
Outpatient Quality Data Reporting Program, which required reporting in
2008 on seven quality measures that are elements of high-quality heart
attack and surgical care, according The Centers for Medicare & Medicaid
Services (CMS).
Read
more...
Window Shuts on December 31 for Making Changes in
Medicare Coverage
New window opens January 1 for changes in Medicare
Advantage plans
Dec. 29, 2008 – Attention last minute shoppers, the
window for making changes to your Medicare prescription drug and health
care coverage is about to slam shut. The Centers for Medicare & Medicaid
Services closes this opportunity at the end of the day on December 31.
Read more...
Quality Rating Stars are Posted on Nursing Home
Compare Website by CMS
Some nursing homes may not like their ratings but
site gets support of aging committee chair
Dec. 22, 2008 - For the first time in history, the Centers for
Medicare & Medicaid Services (CMS) has released quality ratings for each
of the nation’s 15,800 nursing homes that participate in Medicare or
Medicaid. Although some nursing homes were unhappy with their ratings,
Sen. Herb Kohl, chair of the Senate’s committee on aging, gave it a
thumbs up and said he believes it will motivate the nursing homes to
provide the best possible care.
Read
more...
GOA Questions Unexpected Charges to Senior Citizens
by Medicare Advantage Plans
Problems with fee-for-service plans denying charges,
high charge for disenrollment
Dec. 17, 2008 – The timing may not be good – or
maybe it is – but the Government Accountability Office has raised
questions about unexpected costs senior citizens have faced with
Medicare Advantage Programs because of coverage denials and
disenrollment changes. The timing of the report is important because
this is the open enrollment period for Medicare, when seniors can change
the plans they use for service.
Read
more...
More Enhanced Online Tools by Insurance Broker to
Help Seniors Select Medicare Plans
Health Plan One says it has also added more
information on types of Medicare health insurance available
Dec. 15, 2008 – Joining the growing list of
insurance marketers to provide enhanced online tools to help senior
citizens find the Medicare plans that best suit their needs is Health
Plan One. The company says it also expanded its education section to
provide more detailed information on the types of Medicare health
insurance plans available.
Read
more...
Senior Citizens Who Never Signed Up for Medicare
Part B have New Chance January 1
Part B, one of four Medicare parts, covers some
medical expenses not covered by Part A - doctors’ fees,
outpatient hospital visits, and other medical services and supplies
By Oscar Garcia,
Social Security Administration
Dec.
15, 2008 - If you are eligible for Medicare Part B medical insurance,
but you didn’t sign up for it when you first became eligible for
Medicare, you will have another opportunity to apply. Open season
for Medicare Part B runs from January 1 until March 31, 2009.
Read more...
Medicare Proposes Payment Rules to Protect Senior
Citizens from Three Never Events
CMS asks for comments on three National Coverage
Determinations about preventable surgical errors
Dec. 3, 2008 - The Centers for Medicare & Medicaid
Services (CMS) proposed yesterday three national coverage determinations
(NCDs) to establish uniform national policies that will prevent Medicare
from paying for certain serious, preventable errors in medical care. The
following errors, called “Never Events,” being focused on by Medicare
through the NCDs are identified in the National Quality Forum’s (NQF’s)
list of Serious Reportable Events...
Read
more...
Medicare Advantage Plans
Muddy the Water, Do Not Improve Care but Cost More, New Studies Find
Three studies in
Health Affairs today question the
benefits for senior citizens from MA Plans
Nov. 24, 2008 – The private Medicare Advantage
plans have been under heavy fire from Democrats and president-elect
Barack Obama for the extra cost the government pays for them over
traditional Medicare coverage. Now, a series of three reports in
Health Affairs finds the extra cost of the MAs have provided senior
citizens more alternative ways to receive Medicare benefits, but they
have also created more complexity, while generating negligible gains in
quality.
Read
more...
|
When can you
change Medicare drug and health plans?
Dear Marci,
I am unhappy with my current Medicare private health plan
because it does not cover my medicines. When I tried to change
plans, I was told that I could not change until November 15th.
Why is this?
Read Marci's answer - click
here |
Medicare/Medicaid News
Medicare Upgrades Dialysis Facility Compare Website
for Better Comparisons by Seniors
Adds two quality measures showing how well
dialysis patients are treated for anemia, information to help seniors
better understand facility survival rates
Nov. 21, 2008 – The Dialysis Facility Compare
consumer Website created by the Centers for Medicare & Medicaid Services
has been upgraded to include two new quality measures that demonstrate
how well dialysis patients are treated for anemia (low red blood cell
count) as well as updated information that will help patients better
understand survival rates by facility.
Read more...
Medicare Will Not Pay for Bariatric Surgery to Treat
Diabetes Unless Patient Hits BMI of 35
CMS seeks comments on this revision of the bariatric
surgery coverage
Nov. 17, 2008 – Medicare will draw the line at a
body-mass index (BMI) of 35 to determine if a senior citizen is morbidly
obese and qualified to receive coverage for bariatric surgery as a
treatment for beneficiaries with type 2 (or non-insulin-dependent)
diabetes, according to an announcement today by the Centers for Medicare
& Medicaid Services (CMS).
Read
more...
Finance Chair Sen. Baucus Introduces Health Care
Plan Involving Medicare, Medicaid
After a year of preparation by panel, Senator’s “Call
to Action” details policy options, goals for reform; draws backing of
Center for Medicare Advocacy
Nov. 14, 2008 – Health care reform has not been a
high priority for many senior citizens, since they are already covered
by government plans - Medicare and/or Medicaid. A new plan introduced by
one of the most powerful members of the U.S. Senate would have some
impact on these programs, however, and seniors should stay informed.
Read
more...
Medicare News
Medicare Selects Four Companies to Help Seniors
Store Personal Health Records Online
‘It will provide information and tools that will
empower consumers to manage their health better:’ HHS Secretary Mike
Leavitt.
Nov. 12, 2008 – Medicare moved a step closer to
it’s goal of providing senior citizens the opportunity to maintain their
health records online by selecting four personal health record (PHR)
companies to participate in the test run of the program. The Medicare
PHR Choice Pilot program will include seniors in Arizona and Utah.
Read
more...
Medicare Tightens Compensation Rules for Selling
Medicare Advantage, Drug Plans
Industry spokesperson commends CMS on guidelines
for agent and broker commissions
Nov. 11, 2008 - Still trying to cure the problems
in the marketing of the private company Medicare Advantage plans, the
Centers for Medicare & Medicaid Services (CMS) yesterday issued revised
requirements limiting compensation for sales agents and brokers who sell
MAs and prescription drug benefit plan options to people with Medicare.
Read more...
New Effort Launched to Help Hispanic Senior Citizens
Self-Manage their Diabetes
About 18% of seniors on Medicare have diabetes;
Hispanic are four times more likely to be hospitalized due to
uncontrolled diabetes.
| |
By 2050, Hispanics will be the
fastest growing population in the 65 and over age group,
reaching 15 million, and will likely double that figure for
those age 50 and over. |
|
Nov. 7, 2008 – Focusing on Hispanic senior citizens
with diabetes and covered by Medicare, a new effort between the American
Diabetes Association (ADA) and the Patient Education Research Center at
the Stanford University School of Medicine was announced yesterday by
Health and Human Services (HHS). Their goal is to increase the number of
diabetes self-management training programs (DSMT) in the U.S. for
Hispanics and others.
Read more...
Medicare Bumps Pay to Physicians that E-Prescribe;
Cuts Hospital Pay for Injury to Outpatients
Physicians in both the
e-prescribing and PQRI initiatives would receive a 5.1% bonus in
Medicare payments next year
Nov. 3, 2008 -
CMS on Friday confirmed details of an electronic prescribing
incentive program for physicians, scheduled to begin on Jan. 1, 2009,
which would increase Medicare payments for doctors who use the
technology, the
Dallas Morning News reports.
Read more...
Extra Payments to Private Fee-for-Service Medicare
Advantage Plans to Reach $2.5B in 2008
Medicare Advantage Plans proving costly to government
compared to traditional Medicare - early report found all MA plans cost
extra $8.5B
Oct. 21, 2008 - Private fee-for-service (PFFS)
Medicare Advantage plans will be paid an average 16.6 percent more in
2008 compared to what the same enrollees would have cost in the
traditional Medicare fee-for-service program, according to a new report
from The Commonwealth Fund. Although Congress made significant revisions
to policies that affect how PFFS plans operate in 2011 and thereafter,
the legislation is expected to slow enrollment in PFFS plans but not
stop the overpayment for each enrollee.
Read
more...
Free Flu Shots Just One of the Preventive Services
Covered by Medicare
Medicare Rights Center offers free one-on-one
counseling over the phone about Medicare's preventive services
Oct.
15, 2008 - Influenza, commonly referred to as the flu, may not
seem like a dangerous disease, but every year about 20,000 Americans die
because of it. People at high risk for complications from influenza -
most senior citizens with Medicare - should get a flu vaccine.
Read more...
Choosing the Right Hospital Increases Chance of
Survival by 70 Percent Says Annual Study
HealthGrades releases annual study; 41 million
patient records examined; national mortality rate improves
Oct. 14, 2008 – It is a headline that gets the
attention of senior citizens – “Death rate 70% lower at top-rated
hospitals” – since they are the heaviest users of hospital services. This
news is from one of the leading healthcare ratings organizations, HealthGrades, that today released its eleventh annual study of hospital
quality in America. It, along with Medicare, have become leaders in
grading hospital care.
Read
more...
Incentive Pay for Using E-Prescribing is Focus of
CMS National Conference Today
Electronic prescribing of prescriptions could save
thousands of senior citizens from medication errors
Oct. 7, 2008 – E-prescribing, which has the
potential to save thousands of senior citizens from medication errors,
received a big boost today as 1,400 health care professionals and
industry leaders convened in Boston at the National E‑prescribing
Conference hosted by the Centers for Medicare & Medicaid Services (CMS).
Read more...
Screening for Colorectal Cancer in Younger
People Could
Save Millions for Medicare
May be example of how national health
plan could return some savings in Medicare; two other studies find
new technologies improve detection of polyps
Oct.
6, 2008 - The idea of a national health plan, now being debated in the
presidential election, is primarily seen as added government cost, but a
recent study indicates there may also be millions of dollars in savings
to the existing government health insurance program for senior citizens
– Medicare. A new study finds a screening program for colon cancer in
patients starting ten years prior to Medicare eligibility, at age 55
instead of Medicare’s 65, would save at least two dollars for every
dollar spent.
Read
more...
Medicare Getting Tougher on Fraud, Waste, Abuse and
Will Ask for Help from Seniors
New contractors to review paid claims for all
Medicare Part A and B providers to ensure claims meet statutory,
regulatory and policy regulations
Oct.
6, 2008 – After a successful demonstration project recovered over $900
million in overpayments by Medicare, the Centers for
Medicare & Medicaid Services announced today a program it describes as
“aggressive new steps to find and prevent waste, fraud and abuse in
Medicare." And, you may be called on to help. Or, you may be questioned
by a new national recovery audit contractor.
Read
more...
Medicare Stops Paying Hospitals for Harming Patients
Starting
October
Non-Payment rules seek to spur hospitals to improve
patient safety
Oct. 1, 2008 - New federal regulations to restrict
Medicare payments to hospitals for the extra care required to treat
patients harmed by certain preventable infections and medical errors
that occur at the hospital go into effect today. The rules adopted by
the Centers for Medicare and Medicaid Services (CMS) aim to provide
hospitals with a financial incentive to improve patient care.
Read
more...
TRICARE Data Added to Medicare’s South Carolina Test
of Electronic Health Records
Beneficiaries with original Medicare and TRICARE
benefits can add TRICARE data to personal health records
Sept. 23, 2008 - Medicare’s test program that
enables Medicare beneficiaries in South Carolina to collect and then
access information about their health and health care services
electronically will be expanded to offer personal data from TRICARE, the
worldwide health care program for uniformed service members and their
families run by the Department of Defense. The information will be added
for those in Medicare who also receive TRICARE benefits.
Read more...
Medicare Will Not Increase Part B Monthly Premium
for 2009 But High Income Seniors to Pay More
Part A deductible for hospital care boosted $44 to
$1,068
Sept.
19, 2008 – While most of the country is worrying about the devastating
blows being suffered by the U.S. economy, senior citizens find something
to smile about in their financial outlook for 2009. Medicare announced
today the standard Medicare Part B monthly premium will stay the same
next year - $96.40 per month. This follows reports earlier this week by
SeniorJournal.com that the increase in the Social Security
cost-of-living adjustment could be around 6 percent. It wasn’t all good
news from Medicare, however – the highest income seniors will pay higher
rates on Part B and the Part A deductible for hospital care is jumping
to $1,068, $44 over 2008.
Read
more...
Cost of Hospital Care Jumped Most in 2006 for Those
With Least Resources: Uninsured
Total
cost jumped $70 billion in one year to $943 billion: Medicare, Medicaid
more than half
Sept. 18, 2008 – A new government report shows the
less money an American has the more his or her hospital charges jumped
between 2005 and 2006. Hospital charges – what patients are billed for
their rooms, nursing care, diagnostic tests and other services – jumped
from $873 billion in 2005 to $943 billion in 2006, according to the
latest News and Numbers from the Agency for Healthcare Research and
Quality.
Read more...
Senate Bill Would End Practice of Placing Social
Security Numbers on Medicare Cards
Durbin, Bingaman, Kohl introduce bill to protect
Medicare card holders from identity theft
Sept. 17, 2008 – Congress may demand the government
removed Social Security numbers from Medicare identification cards and
communications to beneficiaries as part of the battle against identity
theft. Three Democrats introduced a bill in the Senate today to mandate
these changes, which have been recommended by the Social Security
Administration but ignored by the Centers for Medicare & Medicaid
Services.
Read more...
Advertising by Insurers Favors Medicare Advantage
Over Stand-Alone Drug Plans
Kaiser analysis finds insurers spent more than twice
as much for Medicare Advantage than for stand-alone drug plan ads
Sept.
16, 2008 – As the marketing period for 2009 Medicare plans nears, a new
Kaiser Family Foundation study finds that insurers last year placed
three times more advertisements to promote Medicare Advantage plans than
they did to promote stand-alone Medicare drug plans. The Centers for
Medicare & Medicaid Services also issued new regulations today the add
new restrictions to insurance company marketing of Medicare Advantage
and drug plans. (See sidebar)
Read
more...
Medicare Follows Congressional Directions to Clamp
Down on Insurance Company Marketing
News rules aimed at protecting seniors from
‘deceptive or high-pressure marketing tactics’
Sept.
16, 2008 – There should be a lot more meat and a lot less sizzle in the
pitches tossed at senior citizens this year by insurance companies
selling Medicare prescription drug or Medicare Advantage plans. The
Centers for Medicare & Medicaid Services yesterday released final
regulations – some mandated by Congress – aimed at protecting seniors
from “deceptive or high-pressure marketing tactics.”
Read more...
Senior Citizen Politics
Lawmakers Introduce Bill to Put Hold on Cut to
Medicare Hospice Reimbursement
National hospice group is also suing the Bush
dministration to stop cuts
Sept. 15, 2008 – A bi-partisan bill introduced in
the House and Senate has brought smiles to the faces of leaders of the
National Hospice and Palliative Care Organization (NHPCO). The bill
would prevent the Centers for Medicare & Medicaid Services from
implementing a rule for at least a year that reduces Medicare’s hospice
pay rates. The group has also sued the Bush Administration to stop the
cuts. Read
more...
Medicare News
Original Medicare or Medicare Private Health Plan?
Do You Have the Right One?
Open enrollment period allows senior citizens to
change their Medicare plan
By
Medicare Rights Center
Sept.
13, 2008 - Every year, between November 15 and March 31, everyone with
Medicare can change how they receive their Medicare benefits - to
Original Medicare or to one of the private health plans (also known as
“Medicare Advantage” plans). It is a good time to review your current
coverage and remind yourself of your coverage options.
Read more...
Senior Citizen Advocates Say Medicare Information
Phone Line Must Be Fixed
Thursday hearing of the
Senate Special Committee on Aging focuses on 1-800-Medicare
| |
Daily Reports
KaiserNetwork.org |
|
| |
Below news
report are links to testimony and video of hearing. |
|
Sept. 12, 2008 -
CMS has improved 1-800-Medicare, a toll-free telephone line that
beneficiaries can call for information on the prescription drug benefit,
but the agency needs to address some serious problems that remain before
the next annual enrollment period begins on Nov. 15, advocates for
seniors and lawmakers said on Thursday during a hearing of the
Senate Special Committee on Aging,
CQ HealthBeat reports.
Read
more...
CMS Funds States to Increase Awareness of Home-Based
Alternatives to Institutional Care
Discharge planning process will place greater
emphasis on involving patients and their families in after-care plans at
hospital discharge
Sept. 9, 2008 - Seven states today will receive a
share of over $8 million in federal grants to increase awareness of
home- and community-based long-term care options for people leaving
hospitals who otherwise may enter a traditional nursing home, Center for
Medicare & Medicaid Acting Administrator Kerry Weems announced.
Read more...
Hospice Group Sues Bush Administration to Stop Cut
in Medicare Payment
NHPCO says independent research shows hospice saves
Medicare money
Sept.
6, 2008 - The National Hospice and Palliative Care Organization (NHPCO)
filed a lawsuit Friday to stop a Centers for Medicare and Medicaid
Services' (CMS) rule that would cut Medicare reimbursement rates for
hospice and would irreparably damage hospice programs across the
country. The administration proposal, if enacted, would have a direct,
negative impact on care at the bedside for the nation's most vulnerable
populations, NHPCO contends.
Read more...
Medicare Advantage Plans Cost $8.5 Billion More than
Traditional Medicare in 2008
Extra payments pushed to $33 billion since 2004, will
remain significant even after payment reductions in new legislation
Sept.
5, 2008 - Private Medicare Advantage (MA) plans will be paid an average
12.4 percent more per enrollee in 2008 compared to what the same
enrollee would have cost in the traditional Medicare fee-for-service
program. The cost to Medicare, according to a new report from The
Commonwealth Fund, will be $8.5 billion in 2008, pushing the extra cost
from 2004 to $33 billion.
Read
more...
New Data Added to Government’s Hospital Compare
Website that is Already Booming
More than 2.5 million visitors per month attracted to
features like deaths by hospital and hospital care ratings by consumers
Aug. 20, 2008 - The Website maintained by the
Centers for Medicare & Medicaid Services to provide comparative hospital
information for consumers – Medicare beneficiaries and their caregivers
in particular - has been attracting over 2.5 million visitors per month,
but it is certain to get a big boost this week with the additional of
new information, including more information on death rates at each
hospital. Read
more...
Medicare Could Save Lives, Dollars by Providing
Seniors Nicotine Patches, Hotline
‘Nobody has paid attention to the elderly’ but older
people can benefit from quitting, even if they have smoked for decades
Aug.
18, 2008 - Medicare could possibly save the lives of many senior
citizens and save the government some money in health care costs by
providing nicotine patches and a telephone hotline to seniors who want
to quit smoking.
Read more...
Senior Citizens May Avoid Medicare Marketing Fraud
by Knowing the Rules
Medicare private plans must follow certain rules and
you should know what is allowed
Aug. 13, 2008 – With a huge market to exploit –
abut 36 million senior citizens on Medicare – the hucksters stay busy,
according to congressional reports. The Medicare Rights Center has
produced some tips for older Americans on the rules that must be
followed to market these plans. Sales people who violate these rules
should be suspect.
Read more...
Seniors Better Brush Up on Computers, Medicare to
Let Some Maintain Their Own Health Records
First seniors to try will be in CMS pilot program in
Arizona, Utah
Aug.
12, 2008 – Senior citizens better get onboard the move to accessing
information electronically. They may soon have electronic access to all
their Medicare records and be asked to play a more active role in their
own health care management. The first seniors to get a shot will be
those in Arizona and Utah, where the Centers for Medicare & Medicaid
Services will run a pilot program.
Read more...
Medicare, Medicaid News
CMS Moving to Reduce Disastrous but Preventable
‘Never Events’ in Hospitals
Medicare. Medicaid expect to pay $4.75 billion to
acute care hospitals
Aug. 4, 2008 - The Centers for Medicare & Medicaid
Services (CMS) late last week announced it is taking several actions to
improve the quality of care in hospitals and reduce the number of “never
events” -- preventable medical errors that result in serious
consequences for the patient. Overall, the final rule is estimated to
increase Medicare payments to acute care hospitals by nearly $4.75
billion. Read
more...
Medicare News
Medicare Pays $36 Million to Doctors, Other Health
Professionals for Quality Reports
CMS says payments go to 56,700 health professionals
in Physician Quality Reporting Initiative
July
15, 2008 – Physicians that treat Medicare patients have been fighting in
Congress to prevent a cut in their pay, but many of them will share in
more than $36 million in bonus payments being paid by the Centers for
Medicare & Medicaid Services to 56,700 health professionals for
reporting quality information to Medicare.
Read
more....
Senior Citizens that Bring Companions to Medical
Visits are More Satisfied with Care
Companions are a valuable quality of care resource
that could enhance the experience for millions of vulnerable Americans
July
14, 2008 – Almost two out of every five Medicare patients age 65 or
older appear for their medical visits accompanied by family members or
companions, which seems to contribute to a greater satisfaction with
their doctor and about everything else associated with the visit. The
report in today’s Archives of Internal Medicine, one of the JAMA/Archives
journals, says this is especially true among those in poor health.
Read more...
Medicare Ties 2009 Pay for Outpatient Services to
Quality Reporting
Amount beneficiaries pay for outpatient services will
decline to provide a gradual transition to 20% coinsurance
July
4, 2008 – Medicare has proposed a new rule increasing the pay rate for
hospital outpatient departments and ambulatory surgical centers by three
percent for calendar year 2009, but, those that do not meet quality
reporting requirements will see that pay rate increase to just one
percent. It is the first time Medicare outpatient pay rates have been
associated with the quality of service.
Read more...
Older Nursing Homes Must Add Sprinkler Systems for
Medicare, Medicaid Patients
‘We now will hold all 16,000 nursing homes in the
nation to this standard.” CMS says
June
20, 2008 – Older nursing homes that have escaped modern regulations that
require wall-to-wall life-saving sprinkler systems to protect residents
from fire, will now have get the systems installed, if they want to
continue to serve Medicare and Medicaid beneficiaries.
Read more...
CMS to Add New Five-Star Quality Rating of
Nursing Homes to Compare Website
Nursing Home Compare continuing to add info to
help consumers make choices
June
19, 2008 - The Centers for Medicare & Medicaid Services today announced
it will soon launch a ground-breaking ranking system of America’s
nursing homes, giving each a “star” rating – one star up to five stars.
The ratings will be posted on the agency’s Nursing Home Compare Website
by the end of this year.
Read more...
Medicare Sending Another $15 Million to Help Counsel
Seniors on Health Care Options
Money to state programs is part of $50 million
commitment for 2008
June
6, 2008 – Senior citizens should find it easier to get help in learning
more about their Medicare health care and health insurance choices after
the State Health Insurance Assistance Programs receive the additional
$15 million promised today from the Centers for Medicare & Medicaid
Services.
Read more...
Medicare Changing Reference Book for Approving
Anti-Cancer Chemotherapy Drugs
National Comprehensive Cancer Network Drugs &
Biologics Compendium is new source
June
5, 2008 – Senior citizen Medicare patients and their cancer care
providers will no longer use the American Medical Association Drug
Evaluations (AMA-DE) book to determine which drugs are covered under
Medicare Part B to treat patients undergoing chemotherapy. The Centers
for Medicare & Medicaid Services says it is no longer being updated and
the agency is switching to a new source to ensure the most
up-to-date information.
Read
more...
End-of-Life Options for Medicare Patients Detailed
in New Regulation
Seniors choosing hospice or palliative care have
right to participate in treatment plan and more
June
5, 2008 - Medicare beneficiaries with terminal illnesses have their
right to determine how they receive end-of-life care outlined for the
first time in a new regulation to be published today by the Centers for
Medicare & Medicaid Services.
Read
more...
Visits by Primary Care Physicians Reduce Medicare
Costs at End of Life
‘Decreasing just one hospital day for each Medicare
beneficiary at the end of life could have saved millions of dollars’
June
5, 2008 – About six percent of the people in Medicare die every year.
Surprisingly, they use up about 30 percent of the money Medicare spends
each year. A new study has found that more visits by the primary care
physician in these final months will significantly lower this cost and
result in fewer deaths in hospitals.
Read more...
Senior Citizens Happy with
Medical Care Regardless of
How Much Medicare Spends on Them
Spending varies widely but perceptions of medical
care quality does not
May 27, 2008 – Many senior citizens would be
surprised by the wide differences in per capita expenditures by Medicare
from area to area across the U.S. A new study has found, however, that
those Medicare beneficiaries in the lowest expenditure areas are just as
happy – if not more so – with their medical care as are those in the
high expenditures areas.
Read
more...
Medicare’s Private Fee-for-Service Plans Not Well
Known to Many Seniors; Mixed Reviews
PFFS plans are the fastest-growing Medicare Advantage
plans on the market
May
27, 2008 – Medicare used to be nice and simple, but it offered less.
Now, there are many options about how to obtain your medical insurance
through Medicare but many are still not well understood. In the analysis
below, ElderLawAnswers.com looks at the private fee-for-service plans.
Some advocacy groups think original Medicare is better.
Read more...
Centers for Medicare and Medicaid Joins with FDA in
New Initiative to Improve Patient Safety
Enables CMS to use Medicare Part D claims data for
research, program oversight and evaluation, care coordination, quality
improvement, and performance measurement initiatives
May 22, 2008 - The Centers for Medicare & Medicaid
Services (CMS) will begin sharing data on prescription drug use to help
government agencies and academic researchers improve the safety, quality
and efficiency of health care services, while as part of this new
initiative launched by Health and Human Services, the Food and Drug
Administration will be more proactive in its surveillance of medical
products on the market.
Read more...
Hospital Compare Website to be Promoted Tomorrow in
58 Daily Newspapers
Centers for Medicare & Medicaid Services’ ads
highlight patient ratings for over 1,000 hospitals
May 20, 2008 – Fifty-eight daily newspapers in the
U.S. will be running advertisements tomorrow promoting the Hospital
Compare website managed by the Centers for Medicare & Medicaid Services
(CMS). The ads provide scores from two of the 26 quality and patient
satisfaction measures on the Website for a sample of hospitals in the
community covered by each newspaper.
Read more...
Medicare Drug Program News
CMS Says New Regulations Will Better Protect Seniors
in Advantage and Drug Plans
Proposal tightens marketing rules, protects from
inappropriate cost sharing
May 8, 2008 - The Centers for Medicare & Medicaid
Services (CMS) says in a news release today that it will propose new
regulations and new requirements for Medicare Advantage (MA) health
plans and Medicare prescription drug plans. The CMS statement says the
actions will provide "enhanced protections" for senior citizens enrolled
in these plans.
Read
more...
Medicare to Cover Artificial Hearts When Used in FDA
Approved Clinical Research
Decision revises a long-standing non-coverage policy
May 2, 2008 - Medicare should soon start paying for
artificial hearts, at least when they are implanted as part of a study
that is approved by the Food and Drug Administration (FDA) and that
meets CMS’ Coverage with Evidence Development (CED) clinical research
criteria. Read
more...
HHS Secretary Leavitt Urges Lawmakers, Public to
'Start Now' To Make Changes to Medicare
Congress has only three methods -- raising taxes,
reducing benefits or lowering payments to providers
April 30, 2008 - Health and Human Services
Secretary Mike Leavitt said Tuesday that it is "simply unreasonable" to
think Medicare can maintain its solvency without changes to the program
and that if "we start now, the change can be made over time and with
genuine fairness,"
CQ HealthBeat reports.
Read
more...
Senators Compliment CMS on Nursing Website but Push
Bi-Partisan Bill for More Info
Democrat Kohl, Republican Grassley push bill to
expand transparency
April 28, 2008 – Two U.S. Senators from different
parties came together last Friday to compliment the Centers for Medicare
and Medicaid Services for increasing the information available on their
Website, Nursing Home Compare, but they say the agency has a ways to go
to achieve the transparency and information for consumers called for in
the Senate bill they have crafted.
Read
more...
Health Care System Unprepared for Millions of Baby
Boomers About To Become Eligible for Medicare
U.S. would need 36,000 geriatricians by 2030 to meet
the need
April 16, 2008 -The U.S. health care work force is
"too small and woefully unprepared" to meet the geriatric care needs of
the 78 million aging baby boomers, according to a report released on
Monday by the
Institute of
Medicine, the Wall Street Journal reports (Francis/Fuhrmans,
Wall Street Journal, 4/15). The report, titled "Retooling for an Aging
America: Building the Health Care Workforce," estimates that currently
there is one certified geriatrician for every 2,500 seniors.
Read more...
CMS Proposal Says Medicare Won't Pay Hospitals for
Mistakes Like Cutting Off Wrong Leg
Adding 43 new quality measures on which hospitals
have to report data in order to receive full payment for services
April
15, 2008 - The screws are being significantly tightened to improve the
care of Medicare patients in the hospital and to save millions of
dollars for Medicare by not paying for certain conditions - such as
having the wrong leg cut off - that are caused in the hospital. The
Centers for Medicare & Medicaid Services (CMS) on Monday proposed these
additional steps to strengthen this tie between the quality of care
provided to Medicare beneficiaries and payment for the services. Read
more...
Medicare Advantage Plans to Get More Subsidy, Drug
Plans Get Higher Deductible
CMS to pay 3.6% more to MA plans, drug deductible
goes to $295 from $275 in 2009
|
Read
complete Fact Sheet below news report. |
April 9, 2008 – The subsidy paid by Medicare to
Medicare Advantage Plans will increase by 2.6% next year, despite
consistent opposition by advocacy groups and Democrats to this subsidy,
according to an a Fast Sheet published by the Centers for Medicare and
Medicaid Services on Monday. And, the drug plan providers also got a
small boost in the form of higher deductibles for prescription drug
plans next year.
Read more...
Hospital
Mistakes Kill 270,491 Medicare Patients in 3 Years, Cost $8.8 Billion
HealthGrades says 238,337 deaths preventable, top
hospitals have 43% lower incident rate
April 8, 2008 – Hospital safety incidents caused the
deaths of 270,491 Medicare patients during the years 2004 through 2006,
according to a new report from HealthGrades, which estimates 238,337 of
these deaths were potentially preventable. There were more than a million
safety incidents during the three years studied.
Read more...
End-of-Life Spending Varies Widely for Medicare
Patients with Chronic Conditions
New Jersey spent most, $59,379; North Dakota least,
$32,523; US average $46,412 - Kaiser Network Daily Report
April 7, 2008 - There is wide variation among the
U.S.'s top academic medical centers in spending on care for Medicare
beneficiaries with chronic conditions during the last two years of their
lives, according to the 2008 edition of The Dartmouth Atlas of Health
Care, the
New York Times reports.
Read more...
Medicare Patients Should Expect Better Care at
Dialysis Centers, Says CMS
| |
5 tips to prevent CKD below |
|
CMS issues final rule to update Medicare
‘conditions for coverage’
March 4, 2008 – Senior citizens should expect a
higher quality of care when receiving dialysis, according to an
announcement yesterday from the Centers for Medicare & Medicaid Services
(CMS), that it has released a final rule that will modernize the
Medicare conditions for coverage for the nation’s dialysis centers.
Read more...
Hospital Compare Website Helps Medicare
Beneficiaries Learn More About Local Hospitals
Latest expansion in growing list of consumer Websites
by CMS
March
31, 2008 – For the first time, Medicare consumers have the three
critical elements - quality information, patient satisfaction survey
information, and pricing information for specific procedures - they need
to make effective decisions about the quality and value of the health
care available to them through local hospitals, according to the Centers
for Medicare & Medicaid Services (CMS), which announced changes to the Hospital
Compare Website, one of several by CMS to help consumers make
intelligent health care choices.
Read more...
New Trustees Report Says Medicare Going Broke
Slightly Faster than Expected
‘We need to act quickly and effectively to address
Medicare’s fiscal health’ HHS Secretary
| |
>> Read report by
KaiserNetwork.org below main story. |
|
March 26, 2008 – As many have long known, Medicare
is under a great deal more financial stress than the Social Security
program, and this was confirmed yesterday by the annual report of the
Medicare Trustees that says Medicare’s Hospital Insurance (HI) Trust
Fund will become insolvent slightly earlier in 2019 than reported last year.
Read more...
Fraud Grows as Private Managed Care Takes Over More
Medicaid, Medicare Patients
Wall Street Journal looks at new types of fraud; CVS
pays millions for over-billing Medicaid
March 19, 2008 – The Wall Street Journal today
asserts that as the government shoves more Medicaid and Medicare
beneficiaries to private sector managed care plans, new types of fraud
are emerging. This report hits on the same day as the report that the
giant pharmacy chain CVS agreed to pay nearly $37 million to settle
claims that it fraudulently billed Medicaid. The WSJ also examined the
growing practice of hospitals to reuse medical devices that have
designated for one time use.
Read more...
Medicare, Medicaid Veterans Health Care in
Washington Political Spotlight
Republicans want to cut Medicare, Medicaid;
Democrats want to expand VA health care, key report says traditional
Medicare more efficient than Medicare Advantage
March 12, 2008 – Republicans have introduced their
budget proposal for fiscal 2009, which calls for cuts to the critical
senior citizen programs of Medicare and Medicaid, but that was just the
hottest political move in Washington impacting health care for seniors
and veterans. A committee hearing heard a key report saying traditional
Medicare is a more efficient way of delivering benefits than Medicare
Advantage plans, which supports Democratic efforts to end government
subsidies to the MA plans. The comptroller general criticized the
government in an interview for not acting to secure the financial future
of the entitlement programs. KaiserNetwork.org also reports Democrats
trying to expand the veterans’ health care system.
Read
more...
Kohl Wants Action from Medicare Advantage Plans on
Marketing Reform
'We’ve heard pledges and promises from this group
before,' he says to recent statement by insurance trade group
March 10, 2008 - Sen. Herb Kohl (D-WI) reacted
firmly to
the recent proposal from America’s Health Insurance Plans on reforming
the marketing of Medicare Advantage plans. “We can no longer wait for
these companies to clean up their act while seniors continue to be duped
and misled,” said the chairman of the Senate Special Committee on Aging.
Read more...
Medicare Advantage Plans Higher Than Traditional
Medicare for Some Seniors
Medicare Advantage plans to cost Medicare extra $54
billion from 2009 to 2012, GAO reports
Feb. 29, 2008 - Private Medicare Advantage plans
can cost beneficiaries more than traditional Medicare for home health
care, nursing homes and certain hospital stays, according to a report
released on Thursday by the
Government Accountability Office, the
New York Times reports.
Read
more...
Health Care
Spending to Double to $4.3 Trillion by 2017; Boomers Drive Medicare
Increased use to double prescription drug spending as
prices go down, generics grow
Feb.
26, 2008 – The cost of health care in the U.S. is expected to continue to
outpace inflation and gobble up more of the nation’s gross domestic product
(GDP), according to an analysts by the Centers for Medicare and Medicaid
Services. The report published in Health Affairs says health care spending
will double by 2017, from last year, reaching $4.3 trillion. By 2017 it will
also be consuming 19.5 percent of the GDP.
Read more...
Senior Citizens Living with Heart Failure Increase
as New Cases Decline
Survival gains result in more Medicare patients
living with heart failure
Feb. 25, 2008 – The number of senior citizens being
diagnosed with heart failure has declined over the last ten years. And,
the number of elderly that are living with this condition has increased,
which is, of course, bad news for Medicare which bears the cost of care.
Read more...
Black Women Did Not Benefit as Much as White Women
from Medicare-Paid Mammograms
Breast cancer death rates for the two ethnic groups
used to be nearly identical
By Randy Dotinga, Contributing Writer
Health Behavior News Service
Feb. 19, 2008 - When Medicare began paying for
older women to undergo preventive mammograms in 1991, doctors expected
breast cancer mortality rates to drop. And, as expected, breast cancer
deaths did decrease, but new research has unveiled a discrepancy:
African-American women as a group do not benefit as much as white women.
Read more...
LA Times Says Employers Moving Retirees to Medicare
Advantage; Driving Up Cost for Other Seniors
Senate Kent Conrad (D-N.D.) called the program "a
runaway train
Feb. 12, 2008 – The financial viability of
Medicare, already badly strained, is rapidly getting worse as many local
governments, major corporations and others have learned they can shift
the cost of their retiree health care to the federal government. By
moving the retirees to Medicare Advantage they reduce their cost but
also increase the cost to senior citizens in traditional Medicare.
Read more...
Finance Committee Moves from Stimulus Plan to
Medicare Advantage Problems
Sen. Baucus says, ‘There are too many problems and
abuses.’
Feb. 8, 2008 – Fresh from a victory to get
low-income senior citizens included in the economic stimulus payments,
the Senate Finance Committee is looking at the marketing programs of the
Medicare Advantage Plans, which were supposed to have been corrected
last year.
Read more...
Cost of Entitlement Programs Driven by Skyrocketing
Health Care Costs, Aging Population
Since 1960 health care costs have grown 2.7
percentage points faster per year than the economy as a whole
Feb. 4, 2008 – There are two things that drive the
spiraling costs of the entitlement programs – Social Security, Medicare
and Medicaid – the aging population and the cost of health care. The
administration, in the new 2009 budget introduced today, presents a
brief but informational look at the two problems.
Read more...
Health Care Providers to Bear Brunt of Medicare Cost
Over-Runs in Future
Administration adds budget feature automatically reducing
payments when costs exceed 45% of funding
Feb.
4, 2008 – The 2009 budget submitted today by President Bush will reduce
Medicare spending by $556 billion over 10 years and more than $10
trillion over 75 years. Most of this will probably be paid for by
reduced payments to health care providers due a unique provision the
administration has included to require automatic annual reductions in
fees when funding no longer covers 55 percent of the costs.
Read
more...
Senior Citizen Politics
Senior
Citizen Entitlement Programs Take $208 Billion Hit in Bush Budget
President lays out $3.1 trillion budget and again
says Congress must solve financial future of Medicare, Medicaid, Social
Security
Feb.
4, 2008 - Entitlement programs – short for Medicare, Medicaid and Social
Security – will see spending cuts of $208 billion over the next five years,
if the budget proposed today by President George W. Bush is approved. The
cuts in these programs that primarily affect senior citizens are even larger
than earlier estimates. The President, today, repeatedly laid the problem at
the feet of Congress, as he did in the State of the Union address.
Read more...
Bush Budget Coming Monday Cuts Medicare, Medicaid
but Not Advantage Plan Subsidy
Medicare Payment Advisory Commission says extra fees
paid the Medicare Advantage fee-for-service plans should be cut
Jan. 31, 2008 – President Bush will release his
budget for ht 2009 fiscal year on Monday and it is expected to include
spending cuts in Medicare and Medicaid. He is not likely, however, to
take the suggestion of the Medicare Payment Advisory Commission that
extra fees paid the Medicare Advantage fee-for-service plans be
cut. The Senate Finance Committee seemed to like that idea, too,
at a hearing yesterday.
Read more...
Medicare Making Decisions Based on Profiles that Do
Not Match Beneficiaries
Cardiovascular clinical trial participants differ
in age, sex and country of residence
Jan. 30, 2008 – Despite the skyrocketing costs of
Medicare and the demand for informed decisions, Medicare is using
clinical trials with participants that do not match the characteristics
of beneficiaries to make decisions about cardiovascular products and
services. The trial participants differ in age, sex and country of
residence, according to a report in the January 28 issue of Archives of
Internal Medicine, one of the JAMA/Archives journals.
Read more...
Medicare in 2008 Has Become Costly and Complicated
for Many Senior Citizens
A brief look at the Medicare program and the costs in
2008
Jan. 21, 2008 - In the beginning Medicare was
pretty simple with few decisions required – no real challenge even for
an aging brain to understand, and a cost too low to worry about. That’s
not the case today. The Medicare program is fraught with complicated
decisions that can be costly, if a senior citizen makes the wrong
choice. Below is a brief explanation of the program and the costs for
2008 prepared by SeniorJournal.com and the Medicare Rights Center.
Read more...
Senior Citizens Need to Know Medicare's Nursing Home Care
is Very Limited
ElderLawAnswers.com says Medicare covers "acute" care as opposed to
custodial care
Jan. 18, 2008 - Many people believe that Medicare
covers nursing home stays. In fact Medicare's coverage of nursing home
care is quite limited. Medicare covers up to 100 days of "skilled
nursing care" per illness, but there are a number of requirements that
must be met before the nursing home stay will be covered. The result of
these requirements is that Medicare recipients are often discharged from
a nursing home before they are ready.
Read more...
Ohio, Pennsylvania Join Federal Effort to Increase
Planning for Long-Term Care
‘There’s a widespread misconception that Medicare
pays for long-term care’
Jan. 16, 2008 - Ohio and Pennsylvania will join a
federal program created to increase the public’s awareness about the
importance of long-term care (LTC) planning. The “Own Your Future”
education effort includes information on various ways senior citizens
can finance long-term care, according to Health and Human Services (HHS).
Read more....
Healthcare Spending Hits $2.1Trillion, Growth
Rate Grows in 2006, Says CMS
Growth slight but more than economic growth,
general inflation
| |
See below:
> Healthcare spending by age
> Report by KaiserNetwork.org on CMS news and
reactions |
|
Jan. 8, 2008 - In 2006, U.S. health care
spending reached a total of $2.1 trillion, or $7,026 per person, up
from $6,649 per person in 2005, according to a report by the Centers
for Medicare & Medicaid Services (CMS). The health care spending
growth accelerated slightly in 2006, increasing 6.7 percent compared
to 6.5 percent in 2005, which was the slowest rate of growth since
1999.
Read more...
What to Do When You Realize Your Medicare Drug or
Health Plan Does Not Meet Your Need
Information on drug and health plans provided by Medicare
Rights Center – see links below article
Jan.
4, 2008 – Sometimes, after you picked the Medicare private health or
drug plan that you thought best suited your needs, you discover in the
New Year that the plan you chose doesn’t work for you at all. Perhaps
you’ll find that your doctor or specialist isn’t part of the plan’s
network. Maybe you’ll discover that there are large copays for a
hospital stay or diagnostic procedures. Or maybe when you go to the
pharmacy, you’ll find out that your drug plan doesn’t cover your
medications. Read
more...
Senior Citizens in Medicare Prove Health Improves
with Universal Health Insurance
Those without prior insurance show greatest health
gains after reaching Medicare coverage
Dec. 26, 2007 – As the presidential candidates rush
out their ideas on universal health care, a new study of senior citizens
proves just how valuable it can be to extend health coverage to those
that do not have it. The report published today in the Journal of the
American Medical Association (JAMA) looks at the impact of Medicare,
which provides comprehensive evidence that having health insurance leads
to better health.
Read more...
Medicare Seeks Ways to Get Senior Citizens to Take
Better Care of Their Health
Awards contracts for Senior Risk Reduction
Demonstration as part of Focus on Prevention
Dec. 19, 2007 – Medicare took a big step forward in
its Senior Risk Reduction Demonstration, by awarding contracts to help
find ways to use disease prevention and health programs now used by the
private sector to encourage senior citizens covered by Medicare to do a
better job of managing their health.
Read more...
Medicare, Medicaid Pay Most of 2005 Hospital Bill
that Jumped 90 Percent from 1997
Total bill is $873 billion in 2005 with Medicare
alone paying $411 billion
Dec. 12, 2007 – While the presidential candidates
debate new ideas for universal health care, it is sneaking up behind us.
New numbers show U.S. hospitals charged $873 billion in 2005 – almost a
90 percent increase from the $462 billion charged in 1997. The report
also shows that the majority - about two thirds - of this bill was paid
by Medicare and Medicaid, although other government programs also helped pay
the bill.
Read more...
Three of Four Senior Citizens Refuse Medicare’s Free
Colorectal Cancer Screening
American Cancer Society estimates over 147,000 new
cases and 57,000 deaths this year
| |
Read more about
colorectal cancer and testing below article. |
|
Dec. 10, 2007 - A stunning three out of four senior citizens are
failing to take advantage of the Medicare funded screening for
colorectal cancer. It is stunning because regular colorectal cancer
screening can, in many cases, prevent colorectal cancer altogether,
according to the study published in the January 15 issue of CANCER, a
peer-reviewed journal of the American Cancer Society.
Read more...
Medicare Spends Billions Annually on Products
Available at Lower Prices
New York Times finds better prices from retail, online stores
Nov 30, 2007 - "Despite enormous buying power,
Medicare pays far more" than individuals for equipment and services that
are "available at far lower prices from retail pharmacies and online
stores," the
New York Times reports.
Read more...
Senior Citizen Politics
Drug Company Wants
to Force $2,000 Cancer Drug to Replace $40 Avastin
Sen. Kohl demands info on Genentech move that could cost
Medicare $3 billion annually for treating of macular degeneration
Nov. 29, 2007 – Sen. Herb Kohl (D-WI) stepped to the
front of the line late yesterday to intervene in a proposed limit by
Genentech in the availability of its cancer drug Avastin to certain
pharmaceutical compounding firms and pharmacies. Some physicians have
charged that Genentech’s intention in limiting Avastin’s availability is to
boost sales of Lucentis, a chemically-similar, yet far more expensive drug
also produced by Genentech and approved to treat macular degeneration.
Read more...
Medicare News
Ouch! CMS Publishes Online List of Poorest
Performing Nursing Homes
Wants to help people choose nursing homes for long-term care
Nov. 29, 2007 – Ouch! The Centers for Medicare &
Medicaid Services (CMS) today released the first ranking of the nation’s
poor-performing nursing homes, which it identifies as “Special Focus
Facilities.” CMS says the purpose is to help people choose nursing homes
for long-term care. Read
more...
Medicare Wants to Cut Hospital Pay to Create Quality
of Care Incentive
Proposal would cut all hospitals up to 5% to fund the
incentive pool
Nov. 27, 2007 - The Centers for Medicare & Medicaid
Services (CMS)
on Monday proposed changes to the Medicare hospital reimbursement system
that would reduce payments by a flat rate to create an incentive payment
pool for rewarding hospitals that meet quality-of-care thresholds, the
Wall Street Journal reports.
Read more...
Medicare Demanding Millions from Hospices Because
Patients Lived Too Long
Use of hospice by patients with less predictable life
expectancies, such as Alzheimer's disease and dementia, has
'skyrocketed'
Nov. 27, 2007 - The increase in hospice patients
who live longer than expected has led
CMS (Centers for Medicare & Medicaid Services) to demand
hundreds of millions of dollars in repayments from facilities that
exceed Medicare reimbursement limits, the
New York Times
reports. Read
more...
Osteoporosis Foundation Pushes Bill to Stop Medicare
Cuts for Testing
Group says reimbursement for DXA test will save
Medicare $1.14 billion over five years
Nov. 26, 2007 – The National Osteoporosis
Foundation has issued a news release in support of a House bill (H.R.
4206), which the group says calls for the reversal of drastic cuts in
Medicare reimbursement for Dual Energy X-ray Absorptiometry, DXA, the
imaging procedure "accepted as the gold standard" for diagnosing
osteoporosis.
Read
more...
Medicare Finalizes Expected 10 Percent 2008 Pay Cut
for Physicians
Congress expected to intervene with slight pay
increase
Nov. 2, 2007 – Physicians will receive a 10 percent
pay cut for treating Medicare patients in 2008, according to an
announcement that had been expected from the Centers for Medicare &
Medicaid Services (CMS) on Thursday. CMA said it issued a final
physician payment rule designed to improve accuracy of Medicare payments
and give physicians and health care professionals additional financial
incentives to provide higher quality and value in the delivery of care.
Read more...
Best Health Plan Ranking Includes Those Covering
Medicare, Medicaid
U.S. News & World Report, NCQA release annual
rankings for 500 health plans
Oct. 27, 2007 – A ranking for U.S. health
maintenance organizations and point-of-service plans was released today,
which includes plans that serve Medicare and Medicaid. The U.S. News &
World Report listing, however, may not be of much help to those who
don’t live in the northeast – since that is where all but one of the top
ten plans serving those in the government programs are located.
Read more...
Medicare Project Proves Pressure Ulcers Can be
Stopped in Nursing Homes
Project stopped over two-thirds of the
residents’ serious bed sores
Oct. 24, 2007 – Bed sores, pressure ulcers, decubitus ulcers – they are all the same thing – a killer that often
strikes unsuspecting victims in nursing homes. These flesh killers have
been the target the Centers for Medicare & Medicaid Services, which has
just announced a “remarkably effective” effort in preventing them in
nursing homes.
Read more...
Senior Citizen Patients in Medicare, Medicaid Not
Receiving Quality Care
Elderly patients not given full range of treatments
and services for their conditions
Oct. 17, 2007 - If the care received by vulnerable
older people concurrently enrolled in Medicare and Medicaid was
evaluated on a grading scale, it would squeak by with a barely passing
mark, a new UCLA study has found. They found that “vulnerable
elderly” patients received only 65 percent of the tests and other
diagnostic evaluations and treatments recommended for a variety of
illnesses and conditions, including diabetes and heart disease.
Read more...
Medicare Says Most Acute Care Hospitals Meet
Standards for Full Rate Increase
Senior citizens encouraged to use information as
snapshot of the quality of care being delivered
Oct. 11, 2007 – Medicare reported today that the
“vast majority of the nation’s hospitals” are reporting “valuable data”
about the quality of the care they provide to Medicare beneficiaries and
will receive a full payment rate increase of 3.3 percent next year.
Read more...
Medicare to Test Pay for Performance in Home Health
Care Demonstration
CMS will begin soliciting home health agencies for
the project this fall
Oct. 11, 2007 - The Centers for Medicare & Medicaid
Services (CMS) today announced plans for a home health
pay-for-performance demonstration, an important new step in its drive to
become a more effective purchaser of quality healthcare.
Read more...
Senior Citizen Politics
Senior Citizens Get About Half of Federal Budget in
2005: Social Security, Medicare, Medicaid
Per capita spending highest in Alaska, Virginia,
Maryland, New Mexico, North Dakota
Oct. 9, 2007 - Social Security, Medicare and
Medicaid, programs primarily serving senior citizens, accounted for more
than $1 trillion of the $2.3 trillion the federal government spent in
2005, according to the U.S. Census Bureau, which publishes the only
consolidated source of data on the geographic distribution of federal
expenditures.
Read more...
Medicare News
Senior Citizens Should Review Medicare Health Plan
Options for Changes in 2008
Most private health plans in Medicare change costs,
benefits year-to-year
Oct. 2, 2007 – Everyone enrolled in a Medicare
private health plan should review their health coverage options for next
year, since most private plans will change their costs and benefits,
according to the Medicare Rights Center (MRC).
Read more...
Medicare Part B Monthly Premium Goes Up 3.1% to
$96.40, in 2008
CMS hails it as the smallest premium increase in six
years but partially due to accounting change
Oct. 2, 2007 – The monthly charge for Medicare’s
Part B in 2008 will be $96.40. This 3.1 percent increase over this year
is heralded as the smallest rate increase in six years, but how it got
there is partially due to an accounting error that was corrected by the
Centers for Medicare & Medicaid Services (CMS).
Read more...
Medicare Drug Program News
Nine of Ten Senior Citizens Can Choose Lower Cost
Medicare Drug Plan in 2008
Enrollment change period opens Nov. 15, ends Dec. 31
with chance to lower drug plan cost
Oct.
1, 2007 – When the open enrollment period opens for Medicare on Nov. 15,
over 90 percent of senior citizens with stand-alone Part D prescription
drug plans (PDP) will be able to choose at least one plan for 2008 with
monthly premiums lower than they are paying now.
Read more...
Senior Citizen Health & Medicine
Few Senior Citizens Take Advantage of
Medicare-Provided Cardiac Rehab
Older, female, non-white: biggest offenders; varies,
too, by state
Sept. 26, 2007 – Even though Medicare pays for it,
senior citizens are terrible about following through with cardiac
rehabilitation after a heart attack or coronary bypass surgery. Fewer
than 20 percent – less than one out of five – take advantage of this
free benefit despite strong evidence that it reduces disability and
prolongs life.
Read more...
Medicare News
Seven Medicare Advantage Plans Given Green Light to
Resume Marketing
CMS says they passed ‘comprehensive marketing
review’
Sept.
25, 2007 – Seven of the Medicare Advantage Private-Fee-For-Service plans
that suspended their marketing to senior citizens after complaints of
excessively aggressive marketing are back in business. The Centers for
Medicare & Medicaid Services (CMS) announced yesterday that after being
found compliant with Medicare requirements through a “comprehensive
marketing review,” they may resume marketing.
Read more...
Several Actions Involving Medicare Highlighted by
Kaiser Health Report
CMS
has new requirements on marketing for private fee-for-service Medicare
Advantage plans
Sept. 20, 2007 – There have been several recent
developments related to Medicare. Kaiser Daily Health Policy Report
highlights some of these actions, primarily involving Medicare and the
health care suppliers they deal with in keeping the senior citizen
health insurance program running.
Read more...
Changes to Medicare Pulled from SCHIP Bill by
Negotiators
Democrats vow to make another run at changes to
Medicare
Sept. 19, 2007 – Democrats, particularly in the
House, made a bold attempt to make significant changes in Medicare as
part of the bill to reauthorize and expand SCHIP, the federal program
providing health insurance to lower income children. Those changes to
Medicare were tossed by the Senate and House negotiators, but some
Democrats say they will bring them up again.
Read more...
Senior Citizen Health & Medicine
Websites Comparing Hospital Performance Show Widely Differing Results
Hospital ranked best on one site was ranked worst on another
Sept. 18, 2007 – More than 113 million Americans, many of them senior
citizens, went to the Internet last year to seek health information.
Those checking the sites that compare hospital performance, however, may
not have found accurate information. A look at six of these sites found
Medicare and the non-profit Websites are the best for accessibility and
data transparency.
Read more...
Medicare News
Time to Prepare for Medicare’s Open Enrollment
Season – Original or Advantage?
Medicare Rights Center outlines things senior
citizens should consider
Sept. 17, 2007 - It’s fall again, the season when
health insurance companies begin marketing Medicare private health
plans. Each year, from November 15 to March 31, everyone with Medicare
has the option to change their Medicare coverage, either to Original
Medicare or to one of the private health plans known as Medicare
Advantage plans.
Read more...
Congress Must Standardize Medicare Private Health
Plans like Medigap Plans
Report by consumer groups says it will help
informed consumer choices
Sept. 17, 2007 - Congress must require that the
dizzying array of benefit packages available through Medicare private
health plans be standardized, to help Americans with Medicare make
informed decisions about choosing a health plan and to protect them from
unexpected, high out-of-pocket costs, according to the California Health
Advocates and Medicare Rights Center in a new report.
Read more...
Inequities for Poor, Minorities in Medicare’s
Private Health Plans, Report Says
Medicare Rights Center says payments to private
health plans don’t make sense
Sept. 10, 2007 - Low-income people enrolled in
Medicare private fee-for-service plans pay more for their health care in
some counties than people enrolled in the same plans in neighboring,
more affluent counties, according to a new Medicare Rights Center
report. Read more...
Results Published on Efforts to Reduce Drug Errors
Among Medicare Patients
State-by-state report on QIOs published in Managed
Care
Sept. 7, 2007 – Reducing the number of deaths among
Medicare patients from adverse drug events is a goal of the Quality
Improvement Organizations and a report on their progress has just been
published. The state by state details of how America’s QIOs are working
in partnership with Medicare Part D prescription drug plans (PDPs) and
Medicare Advantage plans (MA-PDs) to improve the quality of prescription
drug therapy for Medicare beneficiaries are reported in a supplement to
the July/August Journal of Managed Care Pharmacy.
Read more...
New Medicare Rule to Stop Physicians from Referring
Patients to Businesses Where They Profit
Final step of physician self-referral prohibition
known as the Stark law
Aug. 28, 2007 – The Centers for Medicare and
Medicaid Services today issued final regulations prohibiting physicians
from referring Medicare patients for certain items, services and tests
provided by businesses in which they or their immediate family members
have a financial interest.
Read more...
National Effort to Improve Health of Hispanic
Elderly Begins in Eight Cities
More Medicare participation and diabetes care are
major targets
Aug. 24, 2007 – Eight communities – mostly large
metropolitan markets – have been selected to participate in a Health and
Human Services pilot initiative aimed at improving the health and
quality of life for Hispanic senior citizens.
Read more...
Medicare’s Refusal to Pay Hospitals for Their Own
Mistakes Draws Editorials
When an auto mechanic breaks one part while fixing
another, would you pay for it?
Aug. 24, 2007 - Not only do hospitals use their
financial muscle to get state and federal lawmakers to protect them from
law suits brought by the errors they commit, they also want Medicare and
insurance companies to pay their bills, even if the cost was due to
their mistake. Medicare has said no more and the insurance industry may
do the same. The action drew mostly praise from U.S. newspapers.
Read more...
Medicare Will Not Pay for Preventable Conditions
Acquired at Hospitals
Most notable are infections; insurance companies
may follow suit
Aug. 20, 2007 - Medicare no longer will reimburse
hospitals for the treatment of preventable errors, injuries and
infections that occur in the facilities under a new rule scheduled for
publication this week, a move that
CMS
officials said could save lives and millions of dollars, the
New York Times
reports. Read
more...
Senior Citizens Deceived by Medicare Private Health
Plans Can Leave Plans
Medicare Rights Center says CMS fails to
explain disenrollment
Aug. 6, 2007 - People in private Medicare health
plans can disenroll from their plans if they signed up after receiving
misleading information, according to the Centers for Medicare and
Medicaid Services (CMS). To date, however, neither CMS nor the insurance
companies that operate Medicare private health plans have informed
people enrolled in these plans that they can leave if they were duped
into signing up.
Read more...
Senior Citizens Turning to Internet for Medicare,
Medicaid Information
'Telehealth' gap could be narrowing for older,
poorer Americans
Aug. 3, 2007 - Despite fears that the elderly and
poor might be missing out on health information on the Internet, a new
study shows that those most in need are bridging the telehealth gap. In
fact, older and poor Americans are likely to use the Internet to seek
out Medicare and Medicaid information, according to researchers Mary
Schmeida. Ph.D., and Ramona McNeal, Ph.D.
Read more...
Senior Citizen Alerts
Medicare Advantage Plans by America’s Health Choice
Terminated in Florida
Centers for Medicare & Medicaid Services cite
delays and denials
July 25, 2007 -
CMS on
Friday terminated Medicare Advantage plans run by
America's Health
Choice of Vero Beach, Fla., citing delays and denials of
medical care, the
South Florida
Sun-Sentinel reports. The termination, which affects about
12,000 beneficiaries, is the first CMS has made for quality-of-care
reasons. Read
more...
Fraud of Senior Citizens by Home Health Agencies is
Target for Government Initiative
Initial efforts to focus on Greater Los Angeles and
Houston areas
July 17, 2007 – An alarm about fraud of senior
citizens by home health care providers was raised today by an
announcement that Health and Human Services will begin an initiative
designed to protect Medicare beneficiaries from fraudulent Home Health
Agency (HHA) providers.
Read more...
Medicare Declares Major Success in Project Treating
Costly Chronic Disease
University of Michigan saved CMS $3.5 million and
improved care
July 12, 2007 – One out of four senior citizens in
Medicare suffers with five or more chronic conditions and they account
for 68 percent of Medicare spending. Medicare declared yesterday that
all participating physician groups participating in a demonstration
project aimed at better managing the health care of those with these
chronic conditions have improved the clinical management of diabetes
patients in the first year of the three-year Medicare Physician Group
Practice (PGP) Demonstration. Diabetes is a major chronic disease among
seniors. Read
more...
Lowering Age for Medicare May Help Offset Later Cost
of Caring for Uninsured
Older adults with chronic disease but no previous
insurance are costly to Medicare, study finds
July 11, 2007 – A new study suggests that lowering
the age to become covered by Medicare would be at least partially offset
by avoiding the additional cost for the government of caring for those
with serious chronic disease that had no insurance before reaching age
65 and joining Medicare. It may also suggest the value of some other
national health care program that would assure adequate care for people
in the earliest stages of their illness.
Read more...
Disenrolling From
Medicare Advantage Plans Difficult for Many Senior Citizens
Medicare Rights Center: no effective, seamless process to do so
July 11, 2007 - The
AP/Lexington
Herald-Leader on Monday examined problems experienced by
Medicare beneficiaries who try to switch their private Medicare
Advantage health insurance plans. "[H]undreds" of elderly residents have
contacted the
Medicare Rights
Center because they cannot disenroll from a private MA plan
purchased "as a result of misleading sales tactics," according to the
AP/Herald-Leader.
Read more...
Fraudulent Medicare Practices by Medical Equipment
Suppliers Targeted by HHS
South Florida and Southern California are focus of
effort
July 10, 2007 - A two-year effort designed to
further protect Medicare beneficiaries from fraudulent suppliers of
durable medical equipment, prosthetics and orthotics supplies (DMEPOS)
was announced today by Mike Leavitt, Secretary of Health and Human
Services. The initiative is focused on preventing deceptive companies
from operating in South Florida and Southern California.
Read more...
Medicare, Medicaid to Consume 20% of Gross National
Product by 2050
Medicare Advantage subsidy making problem worse:
Director Congressional Budget Office
June 22, 2007 -
Congressional Budget Office
Director Peter Orszag on Thursday at a hearing of the
Senate Budget Committee
said that federal spending on Medicare and Medicaid would increase from
about 4.5% to about 20% of U.S. gross domestic product by 2050,
CongressDaily
reports. Read
more...
Senior Citizens Can Now Learn More about Local
Hospital Services
Medicare improves Hospital Compare tools; adds
new information on cost of elective hospital procedures
June 21, 2007 – The Centers for Medicare & Medicaid
Services today unveiled a new version of the Hospital Compare
Website that the agency says gives senior citizens and other consumers
better insight into the quality of care provided by their local
hospitals. CMS also announced the first annual update of pricing and
volume information for certain elective hospital procedures is online.
Read more...
AARP Finds Minorities Not Taking Full Advantage of
Medicare Services
Many senior minorities passing up free flu, pneumonia
shots
June 21, 2007 – African-Americans nor Hispanics
take advantage of Medicare’s free flu and pneumonia immunization at any
where near the rate of their white senior citizen counterparts,
although, these shots can be life-saving. The statistics were revealed
today by AARP at is Diversity and Aging n the 21st Century Conference in
Los Angeles. Read
more...
Medicare to Help Senior Citizens Better Manage Their
Health Care Online
Pilot program to test the use of personal health
records online
June 21, 2007 – A pilot program aimed at
encouraging senior citizens to take advantage of Internet-based tools to
track their health care services and to provide them with other resources
to better communicate with health care providers, was announced
yesterday by Medicare.
Read more...
Bariatric Surgery Appears as Safe for Selected
Medicare Patients as Other Adults, Despite Deaths
Study says ‘surgery should not be denied solely based
on age or Medicare status’
June 18, 2007 – When Medicare began covering
bariatric surgery for severe obesity, there was an alarming number of
deaths reported. A new study, says, however, that complications after
the surgery appear to be similar between Medicare recipients and
non-recipients. They also conclude problems are the same for those under
age 60 as for those passed 60.
Read more...
Congress Advised to Cut Subsidy to Medicare
Advantage Fee-For-Service Plans
Voluntary suspension of marketing the plans warmly
received in Washington
June 18, 2007 – On Friday, seven health insurance
companies under fire for the tactics they were using to convince senior
citizens to buy their Medicare Advantage fee-for-service plans agreed to
stop their marketing until corrections can be made. KaiserNetwork.org
today looks at the reactions and also reports that the
Medicare Payment
Advisory Commission on Friday sent a report to Congress
recommending equalization of reimbursement rates for private Medicare
Advantage plans that are heavily subsidized by the government.
Read more...
Medicare Advantage Fee-For-Service Plans Pledge to
Correct Marketing Ahead of Schedule
President of America's Health Insurance Plans
issues statement
June 16, 2006 – The seven insurance companies that
voluntarily suspended the marketing of their Medicare Advantage
fee-for-service plans in an agreement with the Centers for Medicare and
Medicaid Services have pledged to correct their questionable marketing
tactics "ahead of schedule," according to a statement from the president
of the leading association of insurance companies.
Read more...
Seven Companies Suspend Marketing Medicare
Advantage Fee-For-Service Plans
CMS lays down ‘strict guidelines’ to stop deceptive
marketing
June 16, 2007 - Seven companies have agreed to
voluntarily suspend the marketing of their Medicare plans known as
Private-Fee-For-Service plans, according to the Centers for Medicare and
Medicaid Services. The action late Friday comes months after senior citizens,
advocacy groups and members of Congress began complaining about the
marketing tactics of these private insurance companies. CMS responded
with an investigation that included a “secret shopper” program to learn
the marketing tactics of the companies.
Read more...
Hispanic Senior Citizens Urged to Use Medicare More
by New HHS Program
Hispanic elderly falling behind non-Hispanic whites
in health, study finds
June 15, 2007 – Studies find a growing disparity
between the health of Hispanic senior citizens and the non-Hispanic
white elderly population. Several agencies within Health and Human
Services have joined together to launch a program to encourage Hispanic
elders and their families to take advantage of more Medicare benefits,
including prescription drug coverage, flu shots, diabetes screening and
self-management, cardiovascular screening, cancer screening services and
smoking cessation programs.
Read more...
Senior Citizens' Medicare Bill Could Quadruple by
2020 as Boomers Join, Says Medicare Trustee
Restrictions on health care spending can reduce
Medicare debt up to 40, says study for private enterprise
think tank
June
13, 2007 - Medicare's costs are rising so rapidly that substantial tax
increases, benefit cuts, or a combination of the two will be necessary,
says a Medicare trustee in a study published by a non-profit group that
advocates entrepreneurial private sector alternatives to government
regulation and control. If senior citizens bear the burden, monthly
premiums in constant dollars would have to more than quadruple by 2020.
Read more...
Oncologists Criticize Proposal to Reduce Medicare
Pay for Anemia Medications
CMS is accepting public comments on the proposal
until June 13
June 8, 2007 - A number of physicians attending the
American Society of
Clinical Oncology annual meeting in Chicago this week
expressed concern that
CMS "has
gone too far" with its proposal to limit Medicare reimbursements for the
treatment of cancer patients with anemia medications manufactured by
Amgen
and
Johnson & Johnson,
Dow Jones reports.
Read more...
Little Care Improvement by Hospitals in Medicare
Pay-for-Performance Program
Bonuses of $17.6 million were awarded to 238
hospitals in two years
June 6, 2007 - Hospitals participating in a
Medicare pay-for-performance pilot program were not significantly more
likely than non-participating hospitals to provide better treatment,
according to a three-year study published in the Journal of the American
Medical Association, the Wall Street Journal reports.
Read more...
AMA Survey Says Physicians Won't Take Medicare
Patients if Pay Gets Cut
Campaign to stop physician payment cuts says senior
citizens lose
June 4, 2007 - Medicare patients’ ability to get in
and see the doctor will be severely hampered next year by a steep
Medicare cut to physicians, according to a
new survey released today by the American Medical Association (AMA).
Read more...
Hospital Groups Outraged with Medicare Rule They Say
Will Reduce Pay Increase
‘Back-door budget slashing’ and would cost
hospitals $2.4 billion
June 4, 2007 - Hospital associations are "in a
state of outrage" over a Medicare rule proposed by
CMS that
they say would reduce a scheduled increase in hospital reimbursements by
assuming hospitals will "game the new system," the
Philadelphia
Inquirer reports.
Read more...
Debate over Reducing Medicare Advantage Plan
Payments Continues
CMS Administrator says they offer better preventive
health benefits than traditional Medicare
May 30, 2007 - Lawmakers continue to debate whether
to reduce federal payments to private insurers that administer the
fastest-growing type of Medicare Advantage plans -- private
fee-for-service plans, the
AP/Atlanta
Journal-Constitution reports.
Read more...
Congress, AMA, Advocates All Targeting Medicare
Advantage Private Fee-for-Service Plans
AMA says most members report their patients were
denied coverage
May 24, 2007 – The spotlight in Congress and in
Medicare advocacy circles is increasing the focus on problems in the
Medicare Advantage Private Fee-for-Service Plans. A powerful House
member says he wants to cut the questionable high fees paid to these
plans and the American Medical Association released a survey saying most
of the physicians report that their patients in a Medicare Advantage HMO
or PPO plan were denied coverage of services typically covered in the
traditional Medicare.
Read more...
Understanding of Medicare Advantage Private
Fee-for-Service Gained from New Report
Center for Medicare Advocacy finds problems with
access, consumer protections
May 24, 2007 – A timely new report from the Center
for Medicare Advocacy describes the Medicare Advantage Fee-for-Service
Plans, the rules and regulations in which they operate and compares
these to those for other Medicare Advantage (MA) plans. It also reviews
PFFS plans in three states and compares the cost-sharing expense with
traditional Medicare and with traditional Medicare plus a Medigap
policy. Read
more...
Hospital Death Rates for Heart Attack, Failure in
Medicare Patients to be Published by CMS
Centers for Medicare & Medicaid Services provides
seniors 'Hospital Compare'
May 24, 2007 -
CMS in
June will post the first broad comparison of hospital mortality rates
for heart attack and heart failure in Medicare beneficiaries on the
Hospital Compare
Web site,
USA Today
reports. Hospital mortality rates currently "are among the best-kept
secrets in American medicine" and remain "closely guarded," according to
USA Today. Read
more...
Medicare Advantage Marketing Tactics Get Scrutiny of
Senate Aging Committee
Chairman Kohl notes some plans have announced
reforms
May 16, 2007 – Amidst growing concern about the
aggressive marketing tactics of Medicare Advantage plans, the Senate
Select Committee on Aging held a hearing today that shed new light on
the problem from the point of view of the senior citizen consumer, the
Centers for Medicare and Medicaid and the insurance companies.
Read more...
CMS Questions Marketing Tactics of Medicare
Advantage Plans
They fail to tell seniors they are not 'traditional'
Medicare
May 8, 2007 - The Wall Street Journal on Tuesday
examined how Medicare Advantage private fee-for-service plans are
"coming under increasing fire" from
CMS
officials "worried about
tactics
used to market them" and from lawmakers who believe the plans receive
"exorbitant government payments."
Read more...
Medicare Rights Center Finds Problems with Care from
Private Health Plans
Advocacy group calls for Congress to end the
'Overpayments'
April 30, 2007 – Senior citizens and disabled
Americans discover a host of problems, including unanticipated costs and
barriers to getting care, when they get sick and need care through their
Medicare private health plans, according to a new report from the
Medicare Rights Center.
Read more...
Medicare Trustees Annual Report Requires Response
from Bush on Funding Problem
Second year projecting over 45% must be
funded by general revenues
April 23, 2007 – The Medicare Trustees released
their annual report today, which as expected, projects program costs
financed by general revenues, rather than dedicated revenue, are
expected to exceed 45% in 2013. Because this was the second consecutive
year of such a projection, it triggers a funding warning that requires
President Bush to propose legislation to respond to the issue within 15
days following the release of the Fiscal Year 2009 Budget, which will be
in early February, 2008. There were pieces of good news, however,
including cost projections for the Part D drug program that are 13%
lower than last year.
Read more...
Medicare Proposes Adjusting Hospital Payments Based
on Severity of Illness
Specialty hospitals are a particular focus of the
proposal
April 16, 2007 -
CMS on
Friday announced a proposed rule that would increase the Medicare
inpatient reimbursement rate for hospitals that report data on quality
of care to the agency and base payments on the severity of
beneficiaries' illnesses,
CQ HealthBeat
reports. Read
more...
Medicare Commission Wants Independent Research on
Services
Also calls for reducing confusion on drugs covered in
Part D
April 16, 2007 - The
Medicare Payment
Advisory Commission on Thursday voted to include a
recommendation in a June report to Congress that lawmakers "charge an
independent entity to sponsor credible research on comparative
effectiveness of health care services and disseminate this information
to patients, providers and public and private payers,"
CQ HealthBeat
reports.
Read more...
Medicare Opinion
Three Cheers for Medicare Abdominal Aortic Aneurysm
Screenings
Astounding 80% of AAA found in men, mostly over age
55
By Barry
Thomas
April 12, 2007 - Each year, nearly 200,000 people
in the United States are diagnosed with abdominal aortic aneurysms
(AAAs), a life-threatening, yet typically asymptomatic, weakness in the
wall of the aorta. AAA is a disease that occurs when the walls of
the aorta, the body’s largest blood vessel, weaken and expand.
Over time, the aneurysm may continue to grow. If this happens, the
aorta’s walls can become thin and lose their ability to stretch.
Read more...
Medicare News
Medicare Gives SHIPS $30 Million in New Funds for
Local Counseling
State programs provide local personalized
counseling on health programs, insurance
April 11, 2007 - State Health Insurance Assistance Programs (SHIPS),
which grew in prominence following the funding of the Medicare drug
program, will receive $30 million in new grant funds from the Centers
for Medicare and Medicaid Services. SHIPS provide free personalized
counseling to senior citizens and disabled persons about health
insurance and health programs.
Read more...
Medicare Releases Quality Measures for Physician
Bonus Program
Physician Quality Reporting Initiative will include
74 measures
April 5, 2007 - The Centers for Medicare and
Medicaid Services took a big step forward this week in the 2007
Physician Quality Reporting Initiative, which will pay bonuses for
voluntary reporting, by publishing the detailed specifications for the
74 measures to be used.
Read more...
New Medicare
Bidding Process to Provide Seniors Better Quality, Prices
For certain durable medical equipment, prosthetics,
orthotics, and supplies
April 2, 2007 - The Centers for Medicare & Medicaid
Services (CMS) yesterday issued a final rule that will reduce beneficiary
out-of-pocket costs, improve the accuracy of Medicare’s payments for certain
durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS),
help combat supplier fraud, and ensure beneficiary access to high quality
DMEPOS items and services through a new competitive bidding program. Read
more...
Senior Citizens May Gain More Access to Temporary
Mechanical Hearts
Medicare changes rules that should gain approval
for more hospitals
March 30, 2007 – Senior citizens may have greater
access to temporary mechanical hearts due to action by the Centers for
Medicare & Medicaid Services (CMS) today that should help additional
hospitals become Medicare approved for ventricular assist device (VAD)
implantations.
Read more...
Medicare '45 Percent Rule' Attacked by Families USA
Before Annual Trustees Report
Health care consumer advocates fear drastic action to
be triggered by 'faulty rule'
March 29, 2007 – Anticipating drastic actions that
will impact people on Medicare resulting from the Medicare Trustee's
annual report due to be released by May 1, the Families USA
organization has released a report detailing why the "45 percent
threshold" has no "real significance." Current law mandates the
government take corrective action when the trustees project that 45% of
the program must be financed by the general fund.
Read more...
Medicare Tightening Rules for Transplant Center
Approvals
Goal to ensure effective oversight of transplant
centers
March 23, 2007 – Transplant centers will face
tighter acceptance regulations on approval of a final rule published
today at the Office of the Federal Registry by the Centers for Medicare
& Medicaid Services.
Read more...
Medicare Advocacy Center Says Check Social Security
1099 Carefully
Problems in 2006 prompt warning from advocacy group
March 21, 2007 - Medicare beneficiaries with Social
Security income have been receiving their Social Security 1099 forms,
which report income received in 2006 and deductions taken from that
income, including Medicare premiums. The Medicare Advocacy Center says
senior citizens should check them carefully, based on bad experiences in
2006.
Read more...
Two Medicare Enrollment Periods Will Close at End of
March
Medicare Advocacy Center offers a guide of the
various enrollment periods
March 19, 2007 – Two open enrollment periods for
Medicare will close at the end of March – the General Enrollment Period
for those who did not add Part B earlier, and the Open Enrollment Period
for those who want to enroll, cancel or change a Medicare Advantage
Plan. The Medicare enrollment periods have become extremely confusing
for many senior citizens but, below, the Medicare Advocacy Center
attempts go provide an understandable road map.
Read more...
Medicare Reacts to 'Black Box' Warning About Anemia
Medicines by FDA
Chance of serious, life-threatening side
effects found with ESAs
March 15, 2007 - An alert and health advisory
issued by the Food and Drug Administration last Friday has caused the
Centers for Medicare and Medicaid Services to begin a review of Medicare
policies related to Erythropoiesis Stimulating Agents used in the
treatment of anemia.
Read more...
Medicare Says California Group Latest to Join
Information Sharing Initiative
Physician quality and cost to be made public
March
14, 2007 – A California collaborative is the latest group to join the
national network being established by the Centers for Medicare and
Medicaid Services to share local data with insurers to produce public
reports on physician performance.
Read more...
Democrats Consider Eliminating Extra Pay to Medicare
Advantage Plans to Raise Physician Pay
Medicare Payment
Advisory Commission's report under fire on docs’ pay
March 7, 2007 - Democrats this year are making
"concerted efforts" to cut Medicare Advantage payment rates "as a way to
finance other spending priorities," such as fixing a scheduled 10%
reduction in Medicare physician payments,
CQ HealthBeat
reports.
Read more...
Senior Citizens in the Middle Again of Fight Between
Medicare Advantage Providers and Congress
Medicare Advantage fight a lot like Medicare+Choice debacle
Feb. 28, 2007 – Senior citizens are once again
caught in the middle of a funding fight between insurance companies and
the federal government over the Medicare Advantage Program, which was
known as Medicare+Choice in the last battle in 2003. Today, there are
more than eight million seniors enrolled in this program that provides
more services at a lower cost than traditional Medicare, but are often
more limited in the health care providers available. Congress previously
approved $13 billion in cuts for these programs this year and the new
Congress is considering even more. The insurance companies are saying
this will lead to higher premiums for their senior customers.
Read
more...
National Network of Local Groups to Monitor Health
Care is Launched by HHS
'Value Exchanges' will make quality and cost
findings public
Feb. 28, 2007 – Health & Human Services today
announced an ambitious program to establish local "collaborative
organizations," which will be call "Value Exchanges," to assess the
performance of local health care providers and make the findings public.
They will use "nationally-recognized standards" to measure and improve
quality of care in their areas and will eventually form a
nation-wide network, according to HHS Secretary Mike Leavitt. It is the
latest move in the government's effort to make health care cost and
performance more transparent.
Read more...
Features for Senior Citizens
Options to Broaden Role of Medicare in Long-Term
Care Explored in Georgetown U. Study
By Ellen O’Brien, Health Policy Institute,
Georgetown University
Feb.
18, 2007 - Medicare has contributed substantially to the wellbeing of
the nation’s elderly and people with disabilities. Over the past four
decades, Medicare has helped to improve the health of its beneficiaries
and assure their financial wellbeing. But Medicare also has significant
gaps. Key among them is the fact that Medicare does not pay for
long-term care. Read
more...
Medicare Begins Program to Help Seniors Choose Best
Quality Doctors
Begins comparing physician performance data with
insurance companies
Feb. 15, 2007 – Medicare today announced a program
to combine data from insurance companies with that of Medicare patients
to produce information on the performance of health care providers,
which the Centers for Medicare & Medicaid Services says will "benefit"
Medicare beneficiaries by helping them choose the best performing
doctors.
Read more...
Senior Citizens to See Record Medicare Part B
Premium Increase in 2008
For many seniors the jump will be larger than Social
Security COLA
Feb. 13, 2007 - Medicare Part B premiums are
forecast to increase by $15.90 in 2008, the largest amount in the
history of the program, according to a new analysis by TREA Senior
Citizens League. Part B covers doctors' visits, tests, and outpatient
hospital care. The 2008 Part B premium would represent a 17 percent
increase, from the current $93.50 to $109.40 per month. And, for many,
this increase will eat up all of the increase from Social Security
expected next year.
Read
more...
Medicare Colon Cancer Screening Misses Many
Minorities, Poor, Less Educated
Older patients also less likely to be screened
Feb. 13, 2007 – The expanded Medicare coverage for
colorectal cancer screening has made this critical testing equally
available to all senior citizens, but, like is often the case in disease
screening, minorities, the poor and the less educated are less likely to
be screened. And, somewhat surprising, the study found women less likely
to get a colonoscopy.
Read more...
Senior Citizen Politics
Higher Income Seniors to Pay More for Medicare Drug
Plans in New Budget
Higher premiums based on income began this year for
Part B
Feb
4, 2007 – Higher income senior citizens will pay higher premiums in
Medicare's drug program next year, if a budget proposal by President
Bush is approved. It was reported last week that President Bush will
propose reducing $70 billion from Medicare and Medicaid in his new
budget to be released Monday. The New York Times reports today that one
part of the Bush plan is to impose a surcharge on premiums for
Medicare’s prescription drug benefit, as he did this year for those in
Medicare Part B.
Read more...
Medicare News
Medicare Proposes Expanding Coverage for Carotid
Artery Stenting
Special restrictions for those age 80 and older
February 2, 2007 - Medicare is proposing to expand
coverage for carotid artery stenting to patients who have greater than
80 percent constriction or narrowing of the carotid artery. Medicare is
also proposing to restrict coverage for patients who are 80 years of age
and older to certain approved procedures. Approximately 70 percent of
all strokes occur in people age 65 and older, and it is the third leading
cause of death in the United States and the leading cause of serious,
long-term disability.
Read more...
Senior Citizens with Vision Loss Cost Medicare
Billions, Say Ophthalmologists
Eye docs want more emphasis on preventive care by
Medicare, insurance plans
February 1, 2007 - Senior citizens with vision
problems are costing Medicare more than $2 billion per year in "non-eye
related maladies and healthcare needs," says a study in the journal
Ophthalmology. The American Academy of Ophthalmology, that publishes the
magazine only for its members, responded with a call for Medicare and
insurance plans to put stronger emphasis on preventive eye care.
Read more...
Medicare Rules Possibly Violated by Agents Selling
Fee-for-Service Plans
Medicare releases new pay rates for long-term care
hospitals, lawmakers want them certified
January 29, 2007 - Health care advocates say that
some insurance agents might have violated Medicare rules by soliciting
fee-for-service plans to businesses door-to-door and that some agents
are targeting beneficiaries with cognitive problems or limited English
skills, the
San Francisco
Chronicle reports.
Read more...
Controversy Develops Over Medicare’s
Pay-for-Performance to Hospitals
CMS says improvement ‘substantial,’ study call it
‘modest’
January 29, 2007 – A news release hailing the
success of a two-year project to pay hospitals a bonus for better
performance was issued by the Centers for Medicare & Medicaid Services
last week, but others looking at the results are not so sure of its
success. CMS said it was “substantial improvement” but an independent
study calls the results “Modest,” despite the $8.7 million paid out.
Read
more...
Cash Rewards Make Substantial Improvement in
Hospital Care Finds CMS
CMS pays out almost $9 million to top hospitals in
demonstration
January 28, 2007 – If you want better quality care
from hospitals, give them a cash incentive. The Centers for Medicare &
Medicaid Services says it has produced "substantial improvement" in a
demonstration project it has operated for two years. But, it took a lot
of cash - the reward
payments have been a whooping $8,690,447 for the 115 top performing
hospitals. Read
more...
Medicare Solvency Ranked Third in Health Care
Priorities by Opinion Leaders
Most want Congress to cover uninsured, reduce
health care costs
January 8, 2007 – The top health care priority over
the next five years for Congress should be expanding coverage for the
uninsured, says a new survey. Reforming Medicare to ensure it's
long-term solvency came in third, just below the priority of moderating
rising health care costs. The Commonwealth Fund released the survey
today of what it says are "leading health care experts."
Read more...
Senior Citizen Health & Medicine
Hospital Performance Guidelines for Heart Failure
are Failing Senior Citizens
Medicare & Medicaid pay-for-performance programs
may not work
January 2, 2007 – It sounds like a good idea.
Experts devise a set of performance standards for hospitals that, if
followed, are expected to assure better results in the treatment of the
3.6 million senior citizens hospitalized each year with heart failure.
Since this is the leading cause of hospitalization for senior citizens
covered by Medicare, it makes sense for Medicare to pay a little more
to the hospitals willing to use the standards. But, like many good
ideas, this one, too, has run into a problem - four of five hospital
performance measures for heart failure do not appear to accurately
reflect the quality of care provided.
Read more...
Medicare News
More Senior Citizens Diagnosed at Earlier Stage of
Colon Cancer Due to Medicare Screening Coverage
About 60,000 cases of
colorectal cancer annually among senior citizens
December 20, 2006 – Although it makes logical
sense, it is good to have hard evidence that since Medicare raised the
amount it will reimburse for colon cancer screening in 1998, there has
been an increase in use of colonoscopies by Medicare beneficiaries, and
a rise in the proportion of patients being diagnosed with colon cancer
at an early stage, when it is most treatable.
Read more...
Final Bill of this Congress Saved Physicians from
Big Medicare Pay Cut
AMA says it will help
avert a potential sharp decline in access for America’s senior citizens
December 10, 2006 – Sometime shortly before 4 a.m.
Saturday the Congress finally managed to pass legislation that will
stop Medicare from cutting what it pays physicians. On January 1, a 5.1
percent pay cut was to take affect. The measure passed by large margins
in both the senate and house but was packaged with a number of other
items the congressional leadership wanted to get passed before this
Congress ended. Read
more...
Docs Still Face Medicare Pay Cut as Congress Winds
Down Without Agreement
Veterans stuck too in fight for more health care
funding
December 8, 2006 – Certainly this last day of the lame-duck Congress
will continue into the weekend, but as of late Friday the physicians
still do not have a vote on the bill that would stop a 5.1 percent pay
cut by Medicare that is to become effective on January 1. The House was
expected to vote today on HR 6408 but it had not reached the floor by 5
p.m.
Read more...
Congress Nears Agreement on Stopping Medicare's
Reduction of Physician Pay
Action needed today
if it is to happen before cut kicks in
December 7, 2006 – There appears to be little doubt
this morning that the lame-duck Congress will set aside the pay cut for
doctors that has been mandated by Medicare. Physician reimbursements
will decrease by 5.1% on January 1, without the Congressional override.
Doctors appear to be sincerely concerned about this pay cut, which will
be more than 5.1% in some cases.
Read more...
Lame-Duck Congress Still Wrestling with How to
Reverse Medicare's Proposed Pay Cut for Doctors
December 6, 2006 – The long and costly battle over
Medicare proposed cut in pay to physicians was expected to be settled in
this lame-duck session of Congress but it has hit a snag – how to make
up for the lost funds if the 5.1% pay cut is reversed.
Read more...
Medicare Issues Getting Much Attention in Closing
Days of Congress
Diabetes treatment, review of anemia medication
rules top list
December 6, 2006 – The final days of this Congress
are seeing considerable focus on Medicare issues. A group of senators
have asked Health & Human Services to make diabetes screening and
prevention a "top priority" for Medicare. Tomorrow, the House Ways and
Means Committee will consider Medicare's coverage of anemia medication
used to treat patients with end-stage renal disease. And, outside
Congress, a meeting of advocates expressed their desire to see
"patient-centered care" linked to Medicare reimbursements with
pay-for-performance measures.
Read more...
Medicare Making Changes, Expanding Preventive Care
Services to Fight Diabetes
Expanding access in
rural areas, encouraging physician discussion
December 4, 2006 – Medicare has announced expanded
preventive services and other changes beginning January 1, that will
affect millions of senior citizens battling diabetes. Diabetes screening
was first added to preventive services in 2005, but the agency says it
is making additions and changes that can help seniors with the disease
or even those at risk of diabetes. Below are the highlights.
Read more...
Medicare Advantage Plans Cost $5.2 Billion More than
Fee-for-Service in 2005
Eliminating extra payments could help pay for
enhanced benefits
December 1, 2006 - A report that is sure to add new
ammunition for the Democrats, who want to put an end to the money
Medicare is paying to private Medicare Advantage plans, says the MA
plans were paid an average 12.4% more per enrollee in 2005 compared with
what the same enrollees would have cost in the traditional Medicare
fee-for-service program.
Read more...
Senior Citizens with Higher Incomes May Face
Problems Getting Info on New Income-Based Medicare Premiums
HHS wants IRS to help identify seniors
eligible for drug program subsidy
November 22, 2006 – The new income-based Medicare
Part B premiums, which means higher premiums for higher income
Americans, is headed for a problem, according to the KaiserNet.org daily
report on Medicare. The Social Security Administration may not have
enough people to answer the questions. And, on the other end of the
income scale, Health and Human Services wants the Internal Revenue
Service to provide records to help identify senior citizens eligible for
assistance with the Medicare drug program.
Read
more...
Medicare Posts Pay to Physicians, Hospitals for
Common Treatments as Consumer Guide
November 21, 2006 – The Centers for Medicare &
Medicaid Services has made another step forward in providing consumers
with information on the cost of healthcare services, which is aimed at
helping them make better healthcare decisions. The latest data online is
the payment information for physician and hospital outpatient services.
Read more...
Coalition Pressures Congress to Stop Medicare’s
Therapy Cap
Removing cap allows
seniors to apply for
rehab care above limit
November 13, 2006 – The high profile battles over
Medicare rules that have been taken to Congress for relief have been the
physicians and power wheelchair advocates trying to avoid pay cuts by
Medicare. In less than 50 days, however, one in seven Medicare
beneficiaries will be subject to an “arbitrary financial limit” on
outpatient rehabilitation services, unless a coalition formed by the
American Physical Therapy Association can get help from Congress.
Read
more...
Power Wheelchair Industry, Advocates Winning Battle
over Payment Cuts by CMS
November 10, 2006 – The power wheelchair industry,
and many advocate groups that joined them, seem to be headed for a
significant victory over the rule by the Centers for Medicare & Medicaid
Services that was to make a substantial cut in the payments for these
devices on November 15. Tara Raeber, advocacy communications specialist
at the National Multiple Sclerosis Society's Public Policy Office, said
the new policy reported yesterday for Group 3 devices is "a victory for
the disability community."
Read more...
Senior Citizen Politics
Medicare is Target for Change by Democrats and
Republicans in Weeks Ahead
Republicans may
revoke physician pay cut, Democrats HMO subsidy
November 10, 2006 – A flurry of activity impacting
Medicare is expected in the remaining days of the lame duck Republican
Congress and the early days of the new Democratic Congress. A major
battle is already shaping up over a powerful Democrat’s proposal that
Medicare stop subsidy payments to HMOs. The pay cut for physicians in
2007 that Medicare has declared looks likely to face a move by
Republicans to eliminate the cut or modify it, which may have Democratic
support. Read
more...
Medicare News
Pay-for-Performance Incentives Used for Physicians
and Hospitals by Most HMOs
Medicare eyeing this system by 2009 to increase
healthcare quality
November 6, 2006 – "Pay-for-Performance" is a term
most senior citizens are not familiar with in their healthcare setting,
but this concept of basing financial rewards for doctors and hospitals on their ability to meet certain goals is projected to become a
part of how Medicare does business by 2009. Most HMOs are already using
this compensation system, according to the Agency for Healthcare
Research and Quality.
Read more...
Power Wheelchair Industry Lines Up 44 House Members
Opposing Medicare Fee Cut
They say cuts up to
41 percent will restrict access for senior citizens
November 3, 2006 – The power wheelchair industry
has lined up a bi-partisan group of 44 House members have asked Health
and Human Services (HHS) Secretary Michael Leavitt to delay Medicare
cuts to power wheelchairs, which the group says will make it difficult
for senior citizens and other beneficiaries to receive mobility
equipment. This battle will join the effort by the American Medical
Association to stop a five percent pay cut by Medicare on the
Congressional agenda after the election recess.
Read more...
Medicare Final Rule Cuts Physician Pay Five Percent
for 2007
CMS says rule
encourages more physician-patient communication
November 3, 2006 – The 5.1 percent cut in pay for
physicians in 2007 proposed by Medicare has been reduced to something
closer to 5 percent, according to the final rule issued by the Centers
for Medicare & Medicaid Services this week. The war may not be over,
however, since the American Medical Association was still pressing
Congress to override the pay cut when they took their election recess.
(See AMA reaction in sidebar.)
Read more...
Medicare Announces Preventive Services Available for
Senior Citizens in 2007
November 2, 2006 – Medicare has released the list
of preventive services that will be offered in 2007 to senior citizens
enrolled in Medicare Part B. There is at least one
addition to the "Welcome to Medicare" initial exam -
in 2007, people who are at risk for
abdominal aortic aneurysms may get a referral for a one-time screening
ultrasound. Read
more...
Medicare, Medicaid News
Leslie Norwalk Takes Over as Acting Administrator of
Centers for Medicare & Medicaid Services
Out-going
administrator Mark McClellan says he improved quality of care in
Medicare
October 16, 2006 – Leslie V. Norwalk became the
acting administrator for the Centers of Medicare & Medicaid Services
today, as Dr. Mark McClellan, left the office this weekend as he had
announced on September 5 that he would do. Norwalk, an attorney, has
been serving CMS as deputy administrator.
Read more...
Senior Citizen Health & Medicine
Senior Citizens on Medicare Substantially Lower
Death Risk by Choosing 5-Star Hospitals
HealthGrades 2007 hospital-quality study looked a
40.6 million Medicare records
October 16, 2006 – Senior citizens can lower their
death risk during a hospitalization by 69 percent by getting their
treatment at a top-rated hospital ("5-star") rather than a 1-star rated
hospital. This conclusion was released today as part of the largest
annual study of hospital quality in America by HealthGrades. This
"quality chasm" between the best and poorest-performing hospitals has
grown by approximately 5 percent since last year's study, even as
overall mortality rates have improved by nearly 8 percent.
Read more...
Medicare News
Mobility Industry Predicts Dire Circumstances if
Medicare Proceeds with Pay Cuts for Power Wheelchairs
On Nov.15 Medicare
will reduce reimbursements for power wheelchairs by about an average of
35%
October 11, 2006 - The Scooter Store announced
today that the Centers for Medicare and Medicaid Services' decision to
cut reimbursements by up to 41 percent for most power wheelchairs "will
be devastating" for senior citizens and people living with physical
impairments. And, Black Bear Medical, a leading supplier of durable
medical equipment, said that the cut by Medicare will likely force
lay-offs at their company, as well as other suppliers.
Read more...
Medicare Says it Saved Over $2 Billion in Fraudulent
Claims by Providers
Using new contractors to help identify fraud, waste
and abuse
October 11, 2006 – The Centers for Medicare &
Medicaid Services said today it has save over $2 billion in claims
through aggressive local oversight and specially targeted fraud and
abuse initiatives. Much of the savings have come from focusing on
charges by Independent Diagnostic Testing Facilities. More than 980
referrals have been made to law enforcement since October 2004.
Read more...
Medicare Preventive Care for Senior Citizen Men is
Topic of Podcast
Former HHS Sec. Tommy Thompson
is on MensHealthNetwork.com
September 28, 2006 – Encouraging senior citizen men
to increase their use of the services provided by Medicare to prevent
illness is the first topic in a series of audio podcasts being made by
Tommy Thompson, former Secretary of Health and Human Services and
Governor of Wisconsin. This first of installments planned each Thursday
is available today. The program is named "Medicare's Preventative
Services."
Read more...
Government Paying 60 Percent of Nation's $790
Billion Hospital Bill
Older Americans in
Medicare, Medicaid drive up the cost
September 23, 2006 – The U.S.A. may not need to
adopt legislation establishing a national health care plan – it may just
happen. A new report says the nation's hospitals billed for $790 billion
in 2004, with 60 percent paid by either the federal or state
governments. Read
more...
Medicare Drug Program & Medicare News
Medicare Doughnut Hole and Physician Pay Cuts Get
Attention in House Ways and Means
Congressional session
nears end, members try to tie up loose ends
September 21, 2006 – Two of the hottest Medicare
discussion topics received attention in the House Ways and Means
Committee yesterday – how to plug the drug program "doughnut hole" and
how to make the doctors happy with cuts in their Medicare pay. Democrats
released a report showing the vast majority of those in stand-along drug plans
do not have any coverage when they fall into the doughnut hole.
Republicans were trying to convince physicians to accept quality-of-care
data reporting in exchange for reducing or eliminating their pay cut.
Read
more...
September 13, 2006 – The new Medicare premiums and
deductibles for 2007 were quietly released yesterday in a Fact Sheet
issued by the Centers for Medicare & Medicaid Services. The monthly Part
B premium – the most closely watched charge – will be $93.50 for the
vast majority of senior citizens. For the first time, however, seniors
with higher incomes will pay higher rates. Only seniors earning at least
$80,000 ($160,000 for couples) a year will be subject to this new
surcharge and CMS says it should only be about four percent of current
Part B enrollees. Read
more...
September
12, 2006 – Power wheelchairs and scooters – they have been a God-send
for many disabled senior citizens but a costly headache for Medicare -
prices have escalated as new enhancements were added to these machines
and many with marginal need have found questionable means to get a
physician to prescribe their need to meet Medicare requirements.
Medicare struck back by tightening the rules with tougher requirements
to become effective on October 1. Advocates have organized to bring
pressure on the Centers for Medicare and Medicaid Services to delay
implementation of the new rules.
Read
more...
September 11, 2006 - The Department of Health and
Human Services (HHS) will announce Medicare Part B premiums for 2007
later this month, which will increase significantly for all seniors and
dramatically for seniors with incomes of more than $80,000 per year.
Excluded from their announcement will be the fact that some seniors will
see their premiums jump by as much as 450 percent in just over two
years, according to a news release from the TREA Senior Citizens League.
Read
more...
September 11, 2006 - A Republican dominated
committee quietly added a provision in the 2003 Medicare Modernization
Act, which was not included in the versions passed by the House or
Senate, that will add a surcharge to the Part B Medicare premium for
senior citizens with
incomes above $80,000. It starts with 2007 with a surcharge of 13 percent and will be phased in over three years.
Medicare has made no public mention of this change, not even in the July
fact sheet on Part B costs, which estimated the Part B premium for 2007
would be less than $100 per month.
Read more...
September 11, 2006 - For the first time since Medicare's creation 41
years ago, seniors will no longer pay the same amount for the same
services. Premium rates for Part B - expected to be announced later this
month by the Department of Health and Human Services for 2007 - now will
be means tested, that is, determined based on income.
Read
more...
September 8, 2006 – The American Medical
Association turned up the heat yesterday to press Congress to take
action to stop the planned cut in their payments from Medicare, as it
has in past years. They issued a news release targeting senior citizens
saying a survey it commissioned has found 86 percent of Americans are
concerned that seniors’ access to health care will be hurt if the cuts
go through. The Bush administration "is showing no sign that it wants to
hold off the cuts," and aides to congressional leaders have indicated
that no action is likely to take place, according to the daily report by
KaiserNet.org. (See AMA news release below news report.)
Read more...
September 6, 2006 – President Bush issued a
statement late yesterday saying Mark McClellan, who is resigning as
administration of the Centers for Medicare & Medicaid Services "was
critical in the successful implementation of the Medicare prescription
drug benefit -- the most important health care reform in 40 years."
KaiserNet.org tracked down other reaction and speculation, too, in the
daily report today.
Read more...
September 6, 2006 – Medicare Quality Improvement
Organization contractors will be required to have independent advisory
boards and to help assure beneficiaries better understand how and when
to file complaints, and understand the result and actions that will be
taken to prevent the problems from occurring in the future. These
actions are part of an effort by the Centers for Medicare & Medicaid
Services "to more effectively promote high quality, efficient, and
person-centered care" for people in Medicare.
Read more...
September 5, 2006 - Rumors were rampant over the
weekend that Mark McClellan would resign soon as head of the Centers for
Medicare and Medicaid Services. Although there has been no official
announcement, he has confirmed to the Associated Press he will leave the
office within five weeks, according to a report in KaiserNet.org.
Read
more...
September 2 2006 - Wider adoption of quality
measures used in a groundbreaking Medicare pay-for-performance
demonstration project could save thousands of lives and reduce hospitals
costs, according to an analysis released yesterday by the Premier Inc.
healthcare alliance.
Read more...
August 23, 2006 – All federal agencies, including
Medicare, have been ordered by President George W. Bush to share
information about the quality of care delivered by doctors and
hospitals, as well as the prices paid to these providers. The goal is to
provide consumers with a vast array of data that will help them make
better decisions in choosing hospitals and doctors for their healthcare.
Read more...
August 22, 2006 – Somewhat frustrated by senior
citizens not taking full advantage of the preventive services offered by
Medicare and concerned about costly chronic diseases, the government has
announced it is seeking up to five organizations to participate in a health
promotion and disease prevention program. The program will also involved
85,000 Medicare fee-for-service beneficiaries as volunteers.
Read more...
August 9, 2006 – Medicare moved forward yesterday
to finalize their announced plans to cut reimbursements to physicians by
5.1 percent, which has already been challenged in Congress. Physician
groups predict doctors will cut back on Medicare patients they serve,
while at least one government official thinks it will encourage them to
increase their volume. Medicare also announced a pay increase for
specialty hospitals that report quality care measures. The KaiserNet.org
daily report also says Medicare Advantage plans are showing substantial
growth, particularly with private, fee-for-service plans.
Read more...
July 31, 2006 – Home health agencies will get a 3.1
percent increase in Medicare payments for calendar year 2007, as will
nursing home facilities that furnish certain skilled nursing and
rehabilitation care to Medicare patients recovering from serious health
problems, according to proposals by the Centers for Medicare & Medicaid
Services. Read
more...
July 29, 2006 – The tug-of-war between the Centers
for Medicare & Medicaid Services and the American Medical Association
over what Medicare will pay for physician services, took an interesting
turn last week with the suggestion by the CMS administrator that the
government may scrap the reduction the pay rate if the doctors will
agree to providing the data necessary to measure the quality of care.
This could lead to paying individual physicians at rates tied to the
quality of their service.
Read more...
July 26, 2006 – Medicare, which has been offering a
personalized online record of a senior citizen's Medicare benefits and
personal health information entered by the beneficiary, but the agency
is ready to test the next step – automatic entry of personal health
information. The goal is to allow seniors to better track their health
care services and monitor their own health care.
Read more...
July 24, 2006 – Just a few days ago the president
of the American Medical Association was on the speaking tour and telling
senior citizens that up to 45% of physicians, according to their survey,
will limit their Medicare patients if Congress does not stop a 5% cut in
doctor's payments scheduled by Medicare. The argument received a strong
counter on Friday from a report by the Government Accountability Office
that there is no evidence to expect this to happen, according to a
KaiserNet.org report today.
Read more...
July 21, 2006 – Mark McClellan, administrator of
the Centers for Medicare & Medicaid Services, issued a statement
following the release yesterday of the report by the Institute of
Medicine on the excessive death and injury caused by medication errors.
The study was funded by CMS. McClellan outlined steps Medicare will take
to address the problem.
Read more...
July 17, 2006 – The latest storm engulfing Medicare
is a controversy over changes in the way it will pay hospitals for
services rendered its beneficiaries. Last week 189 members of Congress
sent two letters to Mark McClellan, Administration of the Centers for
Medicare and Medicaid Services, urging his agency to delay until fiscal
year 2008 proposed changes in Medicare payments for inpatient hospital
procedures. Today, the New York Times, takes a close look at the policy
change they say will reduce some payments for complex procedures by 20
to 30 percent. Read
more...
July 12, 2006 – The hidden message in a fact sheet
issued by the Centers for Medicare and Medicaid Services yesterday is
that Medicare Part B premiums for senior citizens will jump to almost
$100 a month next year. The headline on the CMS fact sheet started with,
"Medicaid Spending Projections Down Again." But the big news is rates
are getting ready to take a double digit jump of over 11 percent. (Read
fact sheet below news story.)
Read more...
July 10, 2006 – Consumer-directed health plans will
be available through Medicare Advantage programs in 2007, according to a
news release today by the Centers for Medicare & Medicaid Services. The
new Medical Savings Account (MSA) will provide
beneficiaries access to coverage with additional features similar to
health savings accounts (HSAs) as part of a demonstration program that
permits Medicare Advantage organizations to offer more flexible
accounts. Read more...
June 20, 2006 – The Supreme Court yesterday upheld
the "clawback" provision in the Medicare drug bill that requires states
to reimburse the federal government for some of the drug expenditures on
"dual eligibles." But, in the House Ways & Means Committee the focus was
on preventing Medicare from cutting pay to physicians in 2007, according
to KaiserNet.org. Read
more...
June 20, 2006 - Three out of four stakeholders in
health care improvement agree that “providers are providing better care
because of QIOs,” according to a new independent survey of stakeholders
working closely with Quality Improvement Organizations (QIOs) to improve
care for Medicare beneficiaries.
Read more...
June 19, 2006 – The Centers for Medicare & Medicaid
Services is planning a campaign for the summer to encourage greater use
of preventive services available through Medicare with a special effort
to reach minorities. To add to this national emphasis on preventive
care, the American Medical Association has just elected its first
president with a board certification in preventive medicine.
Read more...
